Long-term benefit of the TAXUS Liberté stent in small vessels and long lesions. TAXUS ATLAS program.

Background: The long-term impact of treating de novo coronary lesions in native vessels and challenging small vessel and long lesion subsets with TAXUS Liberte stents is unknown. This report examines the 3-year efficacy and safety from the TAXUS ATLAS program. Methods and Results: TAXUS ATLAS WH, Small Vessel, and Long Lesion are non-randomized studies comparing TAXUS Liberte (n=871), TAXUS Liberte 2.25 mm (n=261), and TAXUS Liberte 38 mm (n=150) stents, respectively, to case-matched TAXUS Express historical controls. TAXUS Liberte demonstrated comparable 3-year rates of major adverse cardiac events (19.0% vs. 20.2%, P=0.51) in de novo lesions, reduced target lesion revascularization (TLR, 10.0% vs. 22.1%, P=0.008) in small vessels, and reduced myocardial infarction (MI, 2.9% vs. 10.4%; P=0.01) and stent thrombosis (ST, 0.0% vs. 3.9%, P=0.03) in long lesions vs. TAXUS Express. After propensity score adjustment, no statistically significant effect of TAXUS Liberte on TLR (9.7% vs. 16.9%, P=0.12) in small vessels or MI (2.9% vs. 7.9%, P=0.05) in long lesions was noted, although reduced ST (0.0% vs. 2.7%, P=0.02) remained in long lesions. Multivariate analyses demonstrated that TAXUS Liberte treatment significantly reduced TLR by 66% in small vessels, and MI by 75% in long lesions, vs. TAXUS Express. Conclusions: TAXUS Liberte suggests durable 3-year effectiveness in reducing restenosis and improved clinical outcomes in small vessels and long lesions compared with TAXUS Express. (Circ J 2011; 75: 1120-1129)