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EuroIntervention ; 5(1): 67-77, 2009 May.
Article in English | MEDLINE | ID: mdl-19577985

ABSTRACT

AIMS: We report 2-year outcomes in a large unselected drug-eluting stent population (N=7,492) in the TAXUS Express2 ARRIVE post-market surveillance programme (101 U.S. sites). METHODS AND RESULTS: No specific inclusion/exclusion criteria were mandated; patients enrolled at procedure initiation. Two-year follow-up was 94%, with independent adjudication of major cardiac events, monitoring of patients with cardiac events and an additional 10-20% sample by site. Most ARRIVE cases (64%, n=4,794) typified expanded use based on patient/lesion characteristics outside the simple use (single vessel/stent) pivotal trial populations. These expanded use patients had higher 2-year rates than simple use patients for mortality (7.8% vs. 4.2%, P<0.001), myocardial infarction (MI, 3.9% vs. 2.2%, P<0.001), target lesion revascularisation (TLR, 9.2% vs. 5.4%, P<0.001), and stent thrombosis (3.3% vs. 1.4%, P<0.001). Among subgroups with renal disease, chronic total occlusion (CTO), lesion >28 mm, reference vessel diameter (RVD) <2.5 mm, multivessel stenting, acute MI, bifurcation, vein graft, or in-stent restenosis, TLR ranged from 3.8% to 8.9% in year one, and from 1.3% to 6.0% during year two. CONCLUSIONS: Mortality and stent-related events were higher in expanded use than simple use patients in the pivotal trials. ARRIVE provides a detailed estimate of procedural and 2-year outcomes in such real-world patients.


Subject(s)
Angioplasty, Balloon, Coronary/instrumentation , Cardiovascular Agents/administration & dosage , Coronary Artery Disease/therapy , Drug-Eluting Stents , Heart Diseases/prevention & control , Paclitaxel/administration & dosage , Aged , Angioplasty, Balloon, Coronary/adverse effects , Angioplasty, Balloon, Coronary/mortality , Coronary Artery Disease/mortality , Coronary Restenosis/etiology , Coronary Restenosis/prevention & control , Coronary Thrombosis/etiology , Coronary Thrombosis/prevention & control , Female , Heart Diseases/etiology , Heart Diseases/mortality , Humans , Kaplan-Meier Estimate , Male , Middle Aged , Myocardial Infarction/etiology , Myocardial Infarction/prevention & control , Product Surveillance, Postmarketing , Proportional Hazards Models , Prosthesis Design , Registries , Risk Assessment , Time Factors , Treatment Outcome , United States/epidemiology
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