Drug-Eluting Stent Research In Brief

Cypher beats Taxus in new meta-analysis: Johnson & Johnson's Cypher sirolimus-eluting coronary stent is associated with lower rates of myocardial infarction than either Boston Scientific's Taxus drug-eluting stent or bare-metal stents, according to a meta-analysis of 38 trials with 18,023 patients published in the Sept. 15 issue of The Lancet. The meta-analysis, led by Christoph Stettler, University of Bern (Switzerland), is a network of head-to-head comparisons combining direct within-trial comparisons between stents and indirect evidence from other trials, matched to maintain randomization. In the analysis, Cypher's hazard ratio for myocardial infarction is 0.81 compared to bare-metal stents and 0.83 compared to Taxus. (A hazard ratio <1.0 indicates less risk.) There was no difference in mortality or overall stent thrombosis between the stents, but the risk of late stent thrombosis (after 30 days) was higher with Taxus (hazard ratio 2.11 compared to bare-metal stents and 1.85 compared to Cypher.) Also, the lower rate of target lesion revascularization seen using drug-eluting stents over bare-metal stents was more pronounced with Cypher than with Taxus, according to Stettler et al