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SYNTAX Analysis Finds Treatment With TAXUS(R) Express2(TM) Stents More Cost Effective Than Bypass Surgery in Many Patients With Complex Coronary Artery Disease
Date:3/28/2009

$27,560 for PCI v. $33,254 for CABG) (p<0.001), and remained $3,590 lower for PCI than CABG through 12-month follow-up ($35,991 for PCI v. $39,581 for CABG) (p=<0.001). The narrowing in the cost difference between hospital discharge and 12-month follow-up was the result of the cost of repeat revascularization procedures and higher long-term costs of anti-platelet medication in the PCI group.

It has been previously reported that one-year SYNTAX data demonstrated comparable safety for the two treatment groups, with no overall statistically significant differences between PCI and CABG in rates of death or myocardial infarction (MI, or heart attack), although there were significantly more strokes in patients treated with CABG. The rate of repeat revascularization was significantly higher in the PCI group (13.7 % v. 5.9%), although most procedures in the PCI group were repeat PCI, with only a small percentage requiring CABG. However, because of the increased need for repeat procedures, the overall 12-month MACCE (Major Adverse Cardiovascular or Cerebrovascular Event rate, including all-cause death, stroke, MI and repeat revascularization) was significantly higher for PCI.

An earlier analysis of the SYNTAX trial outcomes based on the SYNTAX Score also demonstrated that among patients with a SYNTAX Score in the upper tercile -- those with the most complex disease -- there was a significant increase in MACCE for PCI patients compared with CABG patients, driven by the expected higher rate of revascularization in the PCI group. PCI and CABG patients whose scores fell into the lower or intermediate terciles of complexity had similar rates of MACCE at 12 months. The SYNTAX Score characterizes coronary anatomy based on lesion frequency, complexity and location, and assigns a score to each patient.

The safety and effectiveness of the TAXUS Express2 Stent System have not been established in patients with left main or t
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SOURCE Boston Scientific Corporation
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