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COMPARE: Everolimus-eluting stent bests paclitaxel-eluting stent
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TCT 2009
Results of the COMPARE trial demonstrated that in an all-comer population, the everolimus-eluting stent significantly reduced major adverse cardiac events compared with the paclitaxel-eluting stent, according to presenter Peter C. Smits, MD, of Maasstad Ziekenhuis in Rotterdam, The Netherlands.
Superiority of the everolimus-eluting stent (Xience V, Abbott Vascular) was reached mainly due to less early stent thrombosis and less TLR, according to the presentation.
Data from the COMPARE trial showed that the everolimus-eluting stent bested the paclitaxel-eluting stent (Taxus Liberte, Boston Scientific) in the primary endpoint of combined all-cause death, nonfatal MI and TVR at one year with a rate of 9.1% in the paclitaxel-eluting group (n=903) vs. 6.2% (P=.023) in the everolimus-eluting group (n=897). All-cause death and cardiac death, meanwhile, were equivalent between groups (P=.58 for all-cause death, P=.81 for cardiac death). TVR and ischemia-driven TLR were lower with the everolimus-eluting stent, Smits said (P=.0001 for TVR, P=.0002 for TLR).
The everolimus-eluting stent also outperformed the paclitaxel-eluting stent in the trial’s secondary endpoint of major adverse cardiac events. There was also less stent thrombosis (ARC-defined definite and probable) in the everolimus-eluting stent group vs. the paclitaxel-eluting stent group (P=.002).
“It was remarkable to me how similar these two trials were,” Stone said of SPIRIT IV and COMPARE trials during the discussion portion of the COMPARE trial. “The largest take-home message is there’s a difference between clinical trials we do for regulatory purposes and clinical trials we do to find the truth … You have to do much larger trials in real-world populations to really see the differences between the devices and that’s a trend that needs to continue.” – by Judith Rusk
For more information:
- Smits P. Plenary Session IV. Late Breaking Clinical Trials I. Presented at: Transcatheter Cardiovascular Therapeutics 2009; Sept 21-25, 2009; San Francisco.