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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 on theme: "Pooled Analysis of Trials Comparing Titanium Nitride Oxide Coated Stents with Paclitaxel Eluting Stents in Patients Undergoing PCI Otto M. Hess Swiss Cardiovascular."— Presentation transcript:

1 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

2 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

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

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

5

6 StentThrombosis Death MI TLR CardiacDeath MI or Death

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

8 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

9 Titanium – The Material of Choice ?

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

11 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

12 Baseline characteristics before propensity score matching

13 Baseline characteristics after propensity score matching

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

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

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

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

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

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

20 Clinical outcome in the propensity- score-matched groups

21 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.

22 Forever young


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