Boston Scientific Corporation (NYSE:BSX), Natick, Mass., has
completed enrollment in its SYNTAX clinical trial. SYNTAX is the first
trial to compare the results of drug-eluting stents with those of
cardiac surgery in the most complex patient subsets: those with de novo
lesions involving all three coronary arteries, in the left main coronary
artery, or both. This randomized, controlled clinical trial is designed
to compare the 12-month outcomes of such patients after treatment with
percutaneous coronary intervention (PCI) using the company's
TAXUS(R) Express2(TM) paclitaxel-eluting coronary stent system, versus
the current clinical standard of coronary artery bypass graft (CABG)
surgery.
Previous studies comparing CABG and PCI have used balloon
angioplasty or bare-metal stents, or have been limited to highly
selected patient populations, excluding the type of patient enrolled in
SYNTAX. In contrast, SYNTAX allowed wide latitude in enrolling these
complex patients, with the final decision on whether to randomize a
patient being made by the local interventional cardiologist and
cardiothoracic surgeon. More than 3,000 patients were enrolled at 85
sites in Europe and the United States.
Patients who were deemed eligible for both treatment options were
enrolled in the randomized arm comparing CABG to PCI, which included
1,800 patients (1,090 patients with three-vessel disease and 710
patients with left main (LM) disease). Patients determined to be
eligible for only one of the treatment options (PCI or CABG) were
enrolled in "nested" registries tracking either CABG or PCI
outcomes (more than 1,250 patients combined). The primary endpoint is
the 12-month major adverse cardiac and cerebral event rate, which
includes death, myocardial infarction, repeat revascularization, and
stroke. Results from this randomized arm will provide important clinical
information on the relative merits and risks of CABG to PCI in treating
complex patients who are eligible for both treatment options. In
addition, long-term vascular responses and the relationship of late
angiographic outcomes to clinical outcomes will be assessed in a
substudy of patients with LM disease randomized to PCI or CABG
treatment.
SYNTAX is considered a landmark study that will provide important
data regarding the use of DES in these highly complex patients,
including patients with three-vessel disease, left main coronary artery
disease and patients with diabetes mellitus. The trial's Principal
Investigators are Professor Friedrich Mohr, M.D., Program Director of
the Heart Center/Cardiothoracic Surgery, University of Leipzig, Germany
and Professor Patrick Serruys, M.D., Ph.D., Chief of Interventional
Cardiology, Thoraxcenter-Erasmus University Rotterdam, The Netherlands.
In the United States, the TAXUS Express2 coronary stent system is
indicated for improving luminal diameter for the treatment of de novo
lesions less or equal to 28 mm in length in native coronary arteries
greater or equal to 2.5 to less than or equal to 3.75 mm in diameter.
The TAXUS stent system has not been approved in the U.S. for the
treatment of patients with multi- vessel disease, lesions in the left
main coronary artery or patients with Diabetes Mellitus. Additional
information about the TAXUS stent system is available at
http://www.bostonscientific.com.
Boston Scientific is a worldwide developer, manufacturer and
marketer of medical devices whose products are used in a broad range of
interventional medical specialties.
For more information, http://www.bostonscientific.com or call
508-650-8541.
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