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COMPARE: EES superior to PES at 5 years
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Long-term data from the COMPARE trial demonstrate superiority of everolimus-eluting stents compared with paclitaxel-eluting stents in an all-comers population that underwent PCI.
Researchers aimed to determine whether benefits observed at 1 and 2 years with a second-generation everolimus-eluting stent (EES; Xience V, Abbott Vascular) compared with a second-generation paclitaxel-eluting stent (PES; Taxus Liberte, Boston Scientific) in earlier analyses of the COMPARE trial cohort were maintained through longer-term follow-up.
The cohort included 1,800 patients who underwent random assignment to EES or PES. Five-year follow-up data were available for 1,791 patients.
The primary endpoint, a composite of death, MI or target vessel revascularization, occurred in 18.4% of patients in the EES group vs. 25.1% in the PES group (P = .0005). The researchers reported a 27% relative risk reduction. The reduction in risk with EES was driven by lower MI (7% vs. 11.5%; P = .001) and TVR (7.4% vs. 11.4%; P = .003). Rates of mortality were not significantly different between EES and PES (9% vs. 10.3%; RR reduction = 0.88).
At 5 years, the rate of definite or probable stent thrombosis was 3.1% in the EES group vs. 5.9% in the PES group (P = .005).
The researchers noted that in the first 3 years after EES or PES implantation, hazard curves for MI, TVR and stent thrombosis diverged; however, after 3 years, the hazard curves were parallel.
“This final 5-year report from the COMPARE trial represents the largest study comparing EES to PES in an all-comers cohort with the longest follow-up to date. The results confirm the sustained clinical benefit of EES over PES at 5 years,” the researchers wrote. – by Rob Volansky
Disclosure: The COMPARE trial was supported by Abbott Vascular and Boston Scientific. One researcher reports receiving institutional research grants from Abbott Vascular, Boston Scientific, St. Jude Medical and Terumo and lecture/travel fees from Abbott Vascular; another researcher reports receiving honoraria from Abbott Vascular and Medtronic. The other researchers report no relevant financial disclosures.
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