Pooled Analysis of Trials Comparing Titanium Nitride Oxide Coated Stents with Paclitaxel Eluting Stents in Patients Undergoing PCI Otto M. Hess Swiss Cardiovascular.

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Presentation transcript:

Pooled Analysis of Trials Comparing Titanium Nitride Oxide Coated Stents with Paclitaxel Eluting Stents in Patients Undergoing PCI Otto M. Hess Swiss Cardiovascular Center University Hospital, Bern insel.ch

Conflict of Interest Statement Travel Support Biotronik AG, Baar Surcotec SA, Geneva Bioring SA, Geneva Biosteel GmbH, Aachen Hexacath SA, Paris Speed & Good AG, Ruggell Stent Technology AG, Zug CardioLab SA, Oberbüren

Late Loss Vascular healing Inflammation Camenzind E. et al. Circulation 115: , 2007

Coverage of Overlapping Stents Cypher 2.25 x 23, 2.5 x 28, 3 x 33, 3x23 mm Baseline pre pre

StentThrombosis Death MI TLR CardiacDeath MI or Death

MagicStent Cobalt-Chromium Stent Inflammatory Granuloma Cobalt-Chromium Stent Inflammatory Granuloma

TITAN ® - Stent Titanium-Nitride-Oxide Coating TITAN-Coating (Titanium-Nitride- Oxide) Nitrogen, Oxygen and Titanium atoms are bound by electronic forces. (L. Pauling: classification) Stent geometry Helicoidal Design Material 316 L stainless steel +Titanox- coating Strut thickness 90 microns Crimped profile ~1mm

Titanium – The Material of Choice ?

Titan Stent sputtered Bare metal stent High NO No NO High NO

The SIRTAX II Registry 1607 pts undergoing PCI withTiNOX, SES or PES 542 pts received SES 558 pts received TiNOX 389 pts matched Propensity score matching 507 pts received PES 389 pts matched

Baseline characteristics before propensity score matching

Baseline characteristics after propensity score matching

Histogram of Propensity Scores Kernel-Density and Threshold for Common Support

MACE (death, MI or TVR) p = 1.00p = 0.78 Titan vs. Sirolimus Titan vs. Paclitaxel

Death p = 0.89 p = 0.79 Titan vs. Sirolimus Titan vs. Paclitaxel

Target Lesion Revascularization p = 0.88 p = 1.00 Titan vs. Sirolimus Titan vs. Paclitaxel

Target Vessel Revascularization Titan vs. Sirolimus Titan vs. Paclitaxel p = 0.90 p = 0.41

Myocardial Infarction p = 0.21 p = 0.24 Titan vs. Sirolimus Titan vs. Paclitaxel

Clinical outcome in the propensity- score-matched groups

Conclusions Titanium-coated stents show a similar safety and efficiency as DES of the first generation over 3 years suggesting no benefit of first generation drug eluting stents over Titanium- coated stents Stent thrombosis rates are low for all 3 stent types but are lowest for Titanium-coated stents. However, dual antiplatelet therapy was carried out only for 3 months in Titanium- coated and 12 months in drug-eluting stents Thus, bio-active stents are a true alternative to DES of the first generation specifically in patients with an increased bleeding risk and in elderly.

Forever young