Comparisons of the Short-Term Angiographic Outcomes of Cypher and Taxus Stents Implanted in the Same Patient

BACKGROUND AND OBJECTIVES: Drug-eluting stents (DES) have been shown to substantially reduce both angiographic and clinical restenosis. Cypher(R) (sirolimus-eluting stent, Cordis, Johnson and Johnson, Florida, USA) and Taxus(R) (paclitaxel-eluting stent, Boston Scientific, Boston, USA) are the two most widely used DESs, and they both have distinct pharmacological properties and release kinetics. It has been not studied whether these two DESs show different angiographic outcomes when they are simultaneously implanted in the same patient. SUBJECTS AND METHODS: We retrospectively analyzed the angiographic findings of the short-term follow-up in 34 patients (average age: 63 year old, 9 women) in whom both Cypher and Taxus stents were implanted at the same time for the treatment of obstructive coronary lesion. RESULTS: There was no significant difference in the basal angiographic characteristics of the lesions that had two stents deployed in terms of the AHA/ACC classification, reference diameter, the percent diameter stenosis and minimal luminal diameter. The post-procedure results were similar between the two stents. At 6 months follow-up, the Cypher stent displayed significantly less in-stent lumen loss compared with the Taxus stent (0.16+/-0.04 mm vs 0.27+/-0.04 mm; respectively, p=0.040) and a smaller percent diameter stenosis (15.9+/-1.3% vs 19.9+/-2.2%, respectively, p=0.049). CONCLUSION: The Cypher stent showed significantly less luminal loss during short term follow-up compared with the Taxus stent when implanted in the same patient. This result suggests that in a given individual patient, the Cypher stent induces less neointimal proliferation than does the Taxus stent.

The Elevation of Serum Cardiac Troponin I in Patients with Supraventricular Tachycardia without Evidence of Coronary Artery Disease

BACKGROUND AND OBJECTIVES: Cardiac troponin I (cTnI) is a sensitive and specific marker of myocardial injury. Although myocardial infarction due to coronary artery occlusion is the most common cause of cTnI elevation, its rise has been reported in non-coronary artery diseases such as paroxysmal tachycardia. This study was conducted to determine the incidence of cTnI elevation in supraventricular tachycardia and to identify the factors associated with the rise in cTnI. SUBJECTS AND METHODS: We studied sixty-nine patients (35 males and 34 females, average age: 59+/-14 years) who were admitted for supraventricular tachycardia without evidence of coronary artery disease between January 2001 and December 2004. Coronary artery disease was excluded on the basis of clinical examinations, non-invasive techniques or coronary angiography. The subjects comprised 31 patients with paroxysmal supraventricular tachycardia, 36 patients with atrial fibrillation and 2 patients with atrial flutter. RESULTS: Serum cTnI elevation was observed in 22 of the 69 patients (31.9%) with supraventricular tachycardia. Multiple regression analysis revealed interventricular septal thickness (p<0.0001), the diastolic left ventricular internal dimension (p=0.0416) and hypertension (p=0.0460) as the significant factors related to cTnI elevation. However, the type or duration of tachycardia, the heart rate during tachycardia and patient's age were not related to cTnI elevation. CONCLUSION: This study showed that cTnI elevation may occur not infrequently in the patients with supraventricular tachycardia even in the absence of coronary artery disease. Myocardial hypertrophy and hypertension were the important factors related to cTnI elevation in this setting.