Paclitaxel-Coated Zilver PTX Drug-Eluting Stent Treatment Does Not Result in Increased Long-Term All-Cause Mortality Compared to Uncoated Devices View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2019-09-09

AUTHORS

Michael D. Dake, Gary M. Ansel, Marc Bosiers, Andrew Holden, Osamu Iida, Michael R. Jaff, Aaron E. Lottes, Erin E. O’Leary, Alan T. Saunders, Marc Schermerhorn, Hiroyoshi Yokoi, Thomas Zeller

ABSTRACT

PurposePatient-level data from two large studies of the Zilver PTX drug-eluting stent (DES) with long-term follow-up and concurrent non-drug comparator groups were analyzed to determine whether there was an increased mortality risk due to paclitaxel.MethodsData from the Zilver PTX randomized controlled trial (RCT) and Zilver PTX and bare metal stent (BMS) Japan post-market surveillance studies were analyzed. Five-year follow-up is complete in both DES studies; follow-up for the BMS study was limited to 3 years and is complete. Kaplan–Meier analyses assessed mortality. A Cox proportional hazards model identified significant factors related to mortality.ResultsIn the RCT, there were 336 patients treated with the DES and 143 patients treated with percutaneous transluminal angioplasty (PTA) or BMS. In Japan, there were 904 DES patients and 190 BMS patients. There was no difference in all-cause mortality for the DES compared to PTA/BMS in the RCT (19.1% DES versus 17.1% PTA/BMS through 5 years, p = 0.60) or Japan (15.8% DES versus 15.3% BMS through 3 years, p = 0.89). Cox proportional hazard models revealed that age, tissue loss, and congestive heart failure were significantly associated with mortality in the RCT, and critical limb ischemia, age, renal failure, and gender were significantly associated with mortality in Japan (all p < 0.05). Neither treatment with Zilver PTX (p = 0.46 RCT, p = 0.49 Japan) nor paclitaxel dose (p = 0.86 RCT, p = 0.07 Japan) was associated with mortality.ConclusionAnalyses of the Zilver PTX patient-level data demonstrated no increase in long-term all-cause mortality.Level of EvidenceZilver PTX RCT: Level 1, randomized controlled trial; Japan PMS studies: Level 3, post-market surveillance study. More... »

PAGES

8-19

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00270-019-02324-4

DOI

http://dx.doi.org/10.1007/s00270-019-02324-4

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1120936328

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/31502026


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