Clinical long-term outcome after implantation of titanium nitride-oxide coated stents compared with paclitaxel- or sirolimus-eluting stents: propensity-score matched analysis.

AIMS We performed a propensity score matched analysis to explore whether TiNOX stents are superior to paclitaxel- (PES) and sirolimus-eluting stents (SES) in routine clinical practice. METHODS AND RESULTS A total of 1,607 patients undergoing implantation of SES, PES or TiNOX stents were prospectively entered into a stent registry and followed up for three years. Using propensity score matching, we compared clinical outcome among 319 pairs of patients treated with TiNOX stents or SES and 337 pairs of patients treated with TiNOX stents or PES. The primary outcome MACE, a composite of death, myocardial infarction, and target vessel revascularisation occurred in 20% of patients with TiNOX stents, 19% of patients with SES and 23% of patients with PES at 3-years. The hazard ratio was 1.00 comparing TiNOX stents with SES (95% CI 0.69-1.45, p=1.00), and 0.95 comparing TiNOX stents with PES (95% CI 0.66-1.36, p=0.78). CONCLUSION We did not find evidence to suggest superiority of TiNOX stents over SES or PES. In view of similar clinical outcomes, but with the reduced duration of dual antiplatelet therapy used with the TiNOX stent, we suggest that TiNOX stents may be an alternative to drug-eluting stents in patients unsuitable for long-term dual antiplatelet therapy.

[1]  Peter Jüni,et al.  An overview of the objectives of and the approaches to propensity score analyses. , 2011, European heart journal.

[2]  Peter Jüni,et al.  Comparison of titanium-nitride-oxide-coated stents with zotarolimus-eluting stents for coronary revascularization a randomized controlled trial. , 2011, JACC. Cardiovascular interventions.

[3]  T. Vahlberg,et al.  Long-term clinical outcome with titanium-nitride-oxide-coated stents and paclitaxel-eluting stents for coronary revascularization in an unselected population. , 2010, International journal of cardiology.

[4]  O. Hess,et al.  Randomised comparison of titanium-nitride-oxide coated stents with bare metal stents: five year follow-up of the TiNOX trial. , 2010 .

[5]  M. Niemelä,et al.  Two-year follow-up after percutaneous coronary intervention with titanium-nitride-oxide-coated stents versus paclitaxel-eluting stents in acute myocardial infarction , 2009, Annals of medicine.

[6]  M. Pfisterer,et al.  ESC Forum on Drug Eluting Stents European Heart House, Nice, 27-28 September 2007. , 2008, European heart journal.

[7]  Aloke V. Finn,et al.  Delayed Arterial Healing and Increased Late Stent Thrombosis at Culprit Sites After Drug-Eluting Stent Placement for Acute Myocardial Infarction Patients: An Autopsy Study , 2008, Circulation.

[8]  M. Pfisterer,et al.  Drug eluting and bare metal stents in people with and without diabetes: collaborative network meta-analysis , 2008, BMJ : British Medical Journal.

[9]  M. Niemelä,et al.  Titanium-nitride-oxide coated stents versus paclitaxel-eluting stents in acute myocardial infarction: a 12-months follow-up report from the TITAX AMI trial. , 2008, EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology.

[10]  P. Serruys,et al.  Clinical End Points in Coronary Stent Trials: A Case for Standardized Definitions , 2007, Circulation.

[11]  O. Hess,et al.  Stent coating with titanium-nitride-oxide for prevention of restenosis. , 2006, EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology.

[12]  Michael Joner,et al.  Pathology of drug-eluting stents in humans: delayed healing and late thrombotic risk. , 2006, Journal of the American College of Cardiology.

[13]  H. Yeh,et al.  Comparison of endothelial cells grown on different stent materials. , 2006, Journal of biomedical materials research. Part A.

[14]  F. Eberli,et al.  Randomized Comparison of a Titanium-Nitride-Oxide–Coated Stent With a Stainless Steel Stent for Coronary Revascularization: The TiNOX Trial , 2005, Circulation.

[15]  R. Virmani,et al.  Drug-eluting stents: are they really safe? , 2004, The American heart hospital journal.

[16]  O. Hess,et al.  Stent Coating With Titanium-Nitride-Oxide for Reduction of Neointimal Hyperplasia , 2001, Circulation.

[17]  J. Heckman,et al.  The Economics and Econometrics of Active Labor Market Programs , 1999 .

[18]  S. Steinemann Metal implants and surface reactions. , 1996, Injury.