Final results of a randomized trial comparing the NIR stent to the Palmaz-Schatz stent for narrowings in native coronary arteries

The NIR stent is a novel second generation tubular scent that was designed to overcome some of the limitations of the earlier Palmaz-Schatz (PS) stent design. The NIR Vascular Advanced North American (NIRVANA) trial randomize d 849 patients with single coronary lesions to treatment with the NIR stent or the PS stent. The study was an "equivalency" trial, designed to demonst rate that the NIR stent was not inferior to (i.e., equivalent or better tha n) the PS stent, for the primary end point of target vessel failure (define d as death, myocardial infarction, or target vessel revascularization) by 9 months. Successful stent delivery was achieved in 100% versus 98.8%, respe ctively, with a slightly lower postprocedural diameter stenosis (7% vs. 9%, p = 0.04) after NIR and PS stent placement, respectively. Major adverse ca rdiac events (death, myocardial infarction, repeat target lesion revascular ization) were not different at 30 days (4.3% vs. 4.4%). The primary end poi nt of target vessel failure at 9 months was seen in 16.0% of NIR versus 17. 2% of PS patients, with the NIR proving to be equal or superior to the PS s tent (p <0.001 by test for equivalency). Angiographic restudy in 71% of a p respecified cohort showed no significant difference in restenosis (19.3% vs 22.4%). Thus, the NIR stent showed excellent deliverability with slightly better acute angiographic results and equivalent or better 9-month forget v essel failure tate when compared with the PS stent. (C) 2001 by Excerpta Me dica, Inc.