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At least 19 recordsLinked to original sources
PubMed2004

Direct stenting with TAXUS stents seems to be as safe and effective as with predilatation. A post hoc analysis of TAXUS II.

BACKGROUND AND METHOD: Although direct coronary stenting does not improve angiographic outcome, it makes sense by reducing procedure times, radiation exposure and costs. Other potential advantages of direct stenting may be a reduction of myocardial ischemia time, which could be clinically relevant in high-risk patients. With the introduction of drug-eluting stents, however, concern arose that direct stenting would possibly damage the polymer coating and change or diminish the efficacy of the programmed drug release. Also, concerns about safety by preventing optimal apposition of single stent struts developed. It is the purpose of this paper to retrospectively analyze the data from the TAXUS-II Trial (536 patients) regarding patients with and without direct stenting. While predilatation was recommended per protocol, direct stenting was not forbidden: thus, direct stenting was performed in 49 patients (TAXUS n = 23, control n = 26). RESULTS: In the TAXUS groups, there was no significant difference regarding major adverse cardiac events (MACE; 7.5% vs. 4.3%), angiographic restenosis in the analysis segment (4.8% vs. 4.3%), late loss (0.28 +/- 0.36 vs. 0.33 +/- 0.30 mm) or intravascular ultrasound-(IVUS-)measured volume obstruction (7.95 +/- 9.84% vs. 5.61 +/- 7.91%) at six months between the predilated and directly stented patients. The same was true for the patients receiving the control stent. Compared with the directly stented control group, the statistically significant positive effects of TAXUS direct stenting were maintained, regarding angiographic restenosis in the analysis segment (4.3% vs. 30.8%), late loss (0.33 +/- 0.30 vs. 0.80 +/- 0.62 mm) or IVUS-measured volume obstruction (5.61 +/- 7.91% vs. 22.50 +/- 21.62%) at six months. MACE was reduced from 19.2% to 4.3%; due to the small number of patients this trend did not reach statistical significance. After predilatation, all parameters were significantly improved by the TAXUS stent. CONCLUSION: Comparison of patients receiving TAXUS stents with or without predilatation revealed no differences in clinical, angiographic or IVUS parameters at six months. This suggests that direct stenting with the polymer-based paclitaxel-eluting TAXUS stent is feasible, safe and equally effective. Randomized trials comparing stenting after predilatation versus direct stenting with drug-eluting stents are warranted.

Angioplasty, Balloon, Coronary↗
PubMedDate not supplied

Taxus spp. needles contain amounts of taxol comparable to the bark of Taxus brevifolia: analysis and isolation.

New sources for the antitumor natural product taxol [1] are needed as demands for this promising cancer chemotherapeutic agent increase. Presently, supplies of taxol for clinical studies are obtained from the bark of Taxus brevifolia, a potentially limited source. Using analytical methods, the needles and stems of six Taxus species have been examined for taxol [1] and 10-deacetylbaccatin III [5], a related compound that can be converted to taxol through a semi-synthetic route. Amounts of taxol comparable to quantities reported from the bark of T. brevifolia were found in the needles of four of the Taxus species investigated. In addition, taxol was isolated from the needles of one Taxus species. Thus, Taxus needles may provide a renewable source of this valuable compound.

Alkaloids↗
PubMed2005

Outcomes with the polymer-based paclitaxel-eluting TAXUS stent in patients with diabetes mellitus: the TAXUS-IV trial.

OBJECTIVES: We sought to determine the safety and efficacy of polymer-regulated site-specific delivery of paclitaxel in patients with diabetes mellitus undergoing stent implantation. BACKGROUND: Percutaneous coronary intervention in patients with diabetes is associated with high rates of restenosis and repeat revascularization due to excessive neointimal proliferation, a process that may be blunted with the site-specific delivery of paclitaxel. METHODS: In the TAXUS-IV trial, 1,314 patients were prospectively randomized to the slow rate-release polymer-based paclitaxel-eluting TAXUS stent or the bare-metal EXPRESS stent (Boston Scientific Corp., Natick, Massachusetts). Medically treated diabetes was present in 318 patients (24%), 105 of whom required insulin. RESULTS: Among patients with diabetes, the TAXUS stent, compared to the bare-metal stent, reduced the rate of 9-month binary angiographic restenosis by 81% (6.4% vs. 34.5%, p < 0.0001), and reduced the 12-month rates of target lesion revascularization by 65% (7.4% vs. 20.9%, p = 0.0008), target vessel revascularization by 53% (11.3% vs. 24%, p < 0.004), and composite major adverse cardiac events by 44% (15.6% vs. 27.7%, p = 0.01). The one-year rates of cardiac death (1.9% vs. 2.5%), myocardial infarction (3.2% vs. 6.4%), and subacute thrombosis (0.6% vs. 1.2%) were comparable between the paclitaxel-eluting and control stents, respectively. In the insulin-requiring subgroup, the TAXUS stent reduced angiographic restenosis by 82% (7.7% vs. 42.9%, p = 0.0065), and reduced the one-year rate of target lesion revascularization by 68% (6.2% vs. 19.4%, p = 0.07), a relative reduction similar to patients without diabetes. CONCLUSIONS: The site-specific delivery of paclitaxel after coronary stent implantation is highly effective in reducing clinical and angiographic restenosis in patients with diabetes mellitus.

Antineoplastic Agents↗
PubMed2004

One-year clinical results with the slow-release, polymer-based, paclitaxel-eluting TAXUS stent: the TAXUS-IV trial.

BACKGROUND: The safety and efficacy of the slow-release, polymer-based, paclitaxel-eluting stent after implantation in a broad cross section of de novo coronary lesions at 1 year are unknown. METHODS AND RESULTS: In the TAXUS-IV trial, 1314 patients with single de novo coronary lesions 10 to 28 mm in length, with reference-vessel diameter 2.5 to 3.75 mm, coverable by a single study stent, were prospectively randomized to the slow-release, polymer-based, paclitaxel-eluting TAXUS stent or an identical-appearing bare-metal EXPRESS stent. By actuarial analysis, the TAXUS stent compared with the bare-metal stent reduced the 12-month rates of target-lesion revascularization by 73% (4.4% versus 15.1%, P<0.0001), target-vessel revascularization by 62% (7.1% versus 17.1%, P<0.0001), target-vessel failure by 52% (10.0% versus 19.4%, P<0.0001), and composite major adverse cardiac events by 49% (10.8% versus 20.0%, P<0.0001). The 1-year rates of cardiac death (1.4% versus 1.3%), myocardial infarction (3.5% versus 4.7%), and subacute thrombosis (0.6% versus 0.8%) were similar between the paclitaxel-eluting and control stents, respectively. Between 9 and 12 months, there were significantly fewer myocardial infarctions (0% versus 1.1%, P=0.007), target-vessel revascularizations (2.4% versus 5.8%, P=0.002), and major adverse cardiac events (2.4% versus 6.3%, P=0.0009) in the paclitaxel-eluting stent than in the control stent group, respectively. CONCLUSIONS: The relative efficacy reported at 9 months for the polymer-based, paclitaxel-eluting TAXUS stent compared with the EXPRESS stent is preserved and continues to increase at 1 year, with no safety concerns apparent.

Combined Modality Therapy↗
PubMed2003

Taxus metabolomics: methyl jasmonate preferentially induces production of taxoids oxygenated at C-13 in Taxus x media cell cultures.

Cells from suspension cultures of Taxus cuspidata were extracted with pentane as a source of relatively non-polar taxoids. Of the 13 taxoids identified in this fraction, eight were oxygenated at C-14 and two had not been previously described. These taxoids, along with existing taxoid standards, were employed to profile the metabolites of Taxus x media cv. Hicksii cell suspension cultures induced with methyl jasmonate to produce paclitaxel (Taxol). The majority of the taxoid metabolites produced in these induced cultures were oxygenated at C-13, and not C-14.

Acetates↗
PubMed2002

Multidrug resistant cancer cells susceptibility to cytotoxic taxane diterpenes from Taxus yunnanensis and Taxus chinensis.

Twelve taxane diterpenes (1-12), which were isolated previously from the EtOH extract of the aerial parts of Taxus yunnanensis or Taxus chinensis, were evaluated for cytotoxicity against the multidrug resistant cancer cells KB-VIN and KB-7d. Compounds and showed significant cytotoxicity in these cell lines. Compounds and also demonstrated significant activity against KB-7d. The biflavonoid isolated from T. yunnanensis was only marginally cytotoxic against the A549 (lung) cell line, but a simple methoxylated analogue (14) was inactive.

Antineoplastic Agents, Phytogenic↗
PubMed2000

Taxane diterpenoids from Taxus yunnanensis and Taxus cuspidata.

Chemical examination of the seeds of the Chinese yew, Taxus runnanensis Cheng et L. K. Fu and the Japanese yew, Taxus cuspidata Sieb et Zucc, resulted in the isolation of four taxane diterpenoids. The structures of these taxoids were established as (12alpha)-2alpha-acetoxy-5alpha,9alpha, 10beta-trihydroxy-3,11-cyclotax-4(20)-en-13-one; 2alpha,7beta,13alpha-triacetoxy-5alpha, 9alpha-dihydroxy-2(3-->20)abeotaxa-4(20),11-dien-10-one; 9alpha,10beta-diacetoxy-5alpha-cinnamoyloxytaxa- 4(20),11-dien-13alpha-ol and the known 2alpha,7beta,9alpha,10beta,13-pentaacetoxytax a-4(20),12-diene-5alpha,11beta-diol on the basis of spectral analysis.

Diterpenes↗
PubMed1999

Six new taxane diterpenoids from the seeds of taxus chinensis var. mairei and taxus yunnanensis

Six new taxane diterpenoids and three known 2(3-->20)abeotaxoids were isolated from the seeds of Taxus chinensis var. mairei and of Taxus yunnanensis. Their structures were established as 2alpha, 20-dihydroxy-9alpha-acetoxytaxa-4(20),11-dien-13-one (1), 5alpha-cinnamoyloxy-7beta,10beta, 13alpha-triacetoxy-2(3-->20)abeotaxa-2alpha-ol-4(20),11-dien-9-one (2), 5alpha-cinnamoyloxy-10beta, 13alpha-diacetoxy-2(3-->20)abeotaxa-2alpha,7beta-diol-4(20), 11-dien-9-one (3), 5alpha-cinnamoyloxy-2alpha,7beta,10beta, 13alpha-tetraacetoxy-2(3-->20)abeotaxa-4(20),11-dien-9-one (4), 7-O-acetyltaxine A (5), 2alpha,7beta,10beta, 13alpha-tetraacetoxy-5alpha-phenylisoserinatoxy-2(3-->20)abeotaxa-4(2 0),11-dien-9-one (6), 5-O-acetyltaxinine M (7), 5alpha-hydroxy-2alpha,7beta,10beta, 13alpha-tetraacetoxy-2(3-->20)abeotaxa-4(20),11-dien-9-one (8), and 2alpha,5alpha-dihydroxy-7beta,10beta, 13alpha-triacetoxy-2(3-->20)abeotaxa-4(20),11-dien-9-one (9), on the basis of 1D and 2D NMR spectroscopic analysis. Compound 1, as a new compound isolated from T. chinensis var. mairei, is a rare example of a taxane with a 4,11-diene unit, which is considered to be an important intermediate in the biogenesis of taxoids. Compounds 2-4, 6, and 7 are new compounds, isolated from T. yunnanensis, which also afforded the known compounds 5, 8, and 9.

Journal Article↗
PubMed2006

Comparison of short- and mid-term outcomes between CYPHER and TAXUS stents in patients with complex lesions of the coronary arteries.

BACKGROUND: Drug-eluting stent (DES) could obviously reduce in-stent restenosis, which has been proved by international multi-center clinical trials. However, the types of the lesions for stenting were highly selected in these trials. Up to now, there has been no large scale study on the effect of DES in treating complex lesions in real world. Although REALITY trial was just reported during American College of Cardiology Congress 2005, the entry criteria for lesions were limited to one or two de novo lesions. This study was conducted to compare the short- and mid-term clinical outcomes between sirolimus-eluting stent (CYPHER stent) and paclitaxel-eluting stent (TAXUS stent) in patients with complex lesion. METHODS: This is a retrospective study. From April 2002 to June 2004, a total of 1061 patients were treated with DES in Fu Wai Hospital, of which, 611 patients (642 lesions with 698 CYPHER stents) were in CYPHER group, and 450 patients (534 lesions with 600 TAXUS stents) were in TAXUS group. There was no significant difference in clinical data and lesion types between CYPHER group and TAXUS group. RESULTS: Success rates of stent implantation were 99.2% and 98.8% in CYPHER and TAXUS stent groups respectively. The major adverse cardiac events (MACE) during in-hospital and 6-8-month follow-up were 0.7% and 2.3% in CYPHER stent group versus 1.3% and 3.2% in TAXUS stent group. There was no significant difference in MACE rate between these two groups. Restenosis rate was a little higher in TAXUS stent group than that in CYPHER stent group (14.0% vs 7.3%), but there was no significant difference. The incidence of acute occlusion of side branch after implanting DES in main vessel was 6.9% in CYPHER group and 11.9% in TAXUS group (P < 0.05). CONCLUSIONS: CYPHER and TAXUS DES were safe and effective in patients with complex lesion. Clinical outcomes of CYPHER stent were better than TAXUS stent in bifurcation lesions. There was an increasing tendency in restenosis rate and late thrombosis in TAXUS group as compared with that of CYPHER group.

Coronary Disease↗
PubMed2003

TAXUS I: six- and twelve-month results from a randomized, double-blind trial on a slow-release paclitaxel-eluting stent for de novo coronary lesions.

BACKGROUND: The TAXUS NIRx stent (Boston Scientific Corp) provides local delivery of paclitaxel via a slow-release polymer coating. The TAXUS I trial was the first in-human experience evaluating safety and feasibility of the TAXUS NIRx stent system compared with bare NIR stents (control) (Boston Scientific Corp) for treatment of coronary lesions. METHODS AND RESULTS METHODS AND RESULTS: The TAXUS I trial was a prospective, double-blind, three-center study randomizing 61 patients with de novo or restenotic lesions (< or =12 mm) to receive a TAXUS (n=31) versus control (n=30) stent (diameter 3.0 or 3.5 mm). Demographics, lesion characteristics, clinical outcomes were comparable between the groups. The 30-day major adverse cardiac event (MACE) rate was 0% in both groups (P=NS). No stent thromboses were reported at 1, 6, 9, or 12 months. At 12 months, the MACE rate was 3% (1 event) in the TAXUS group and 10% (4 events in 3 patients) in the control group (P=NS). Six-month angiographic restenosis rates were 0% for TAXUS versus 10% for control (P=NS) patients. There were significant improvements in minimal lumen diameter (2.60+/-0.49 versus 2.19+/-0.65 mm), diameter stenosis (13.56+/-11.77 versus 27.23+/-16.69), and late lumen loss (0.36+/-0.48 versus 0.71+/-0.48 mm) in the TAXUS group (all P<0.01). No evidence of edge restenosis was seen in either group. Intravascular ultrasound analysis showed significant improvements in normalized neointimal hyperplasia in the TAXUS (14.8 mm3) group compared with the control group (21.6 mm3) (P<0.05). CONCLUSIONS: In this feasibility trial, the TAXUS slow-release stent was well tolerated and showed promise for treatment of coronary lesions, with significant reductions in angiographic and intravascular ultrasound measures of restenosis.

Aged↗
PubMed2006

Procedural success and 30 day outcomes between CYPHER and TAXUS stent implantation for the treatment of bifurcation lesions--a single-center experience.

BACKGROUND: There are fundamental differences between the CYPHER and TAXUS stents, including the drug coatings, polymers and stent platforms. In this registry study, we sought to investigate the procedural success and 30-day outcomes of the patients who were treated with either the CYPHER or TAXUS stents for de novo bifurcation lesions. METHODS: A total of 83 patients with 85 de novo bifurcation lesions treated with either the CYPHER or TAXUS stents from June 2002 to May 2004 were recruited for analysis. RESULTS: True bifurcation lesion, stenosis in both the main vessel and side branch, constituted 39% of the treated lesions. The procedural success was 96% and 93% in CYPHER and TAXUS groups, respectively. Bifurcation stenting was performed in 13% of the overall study population. Two patients each in the CYPHER (8%) and TAXUS (3%) groups had a slight elevation of cardiac enzymes after the procedure. At 30-day follow up, 2 patients in the TAXUS and none in the CYPHER group had subacute stent thrombosis (SAT), leading to myocardial infarction (MI). Urgent target vessel revascularization (TVR) was attempted in these 2 patients, but failed in 1 of them. A total of 6 adverse events (1 stroke, 2 MIs and 3 TVRs) from 4 patients (2 patients with 2 adverse events) in the TAXUS group, and 1 adverse event (TVR) in the CYPHER group were reported. The adverse event rate was slightly, but not significantly, higher in the TAXUS group (7% vs. 4%; p = 1.000). CONCLUSION: Our results suggest that the procedural success and 30-day outcomes were similar in patients who had been treated with either the CYPHER or TAXUS stent for de novo bifurcation lesions. The occurrence of SAT in the TAXUS but not in the CYPHER group warrants further evaluation.

Acute Disease↗
PubMed2005

Polymer-based paclitaxel-eluting stents reduce in-stent neointimal tissue proliferation: a serial volumetric intravascular ultrasound analysis from the TAXUS-IV trial.

OBJECTIVES: The aim of this study was to use serial volumetric intravascular ultrasound (IVUS) to evaluate the effects of polymer-based, paclitaxel-eluting stents on in-stent neointima formation and late incomplete stent apposition. BACKGROUND: The TAXUS-IV trial demonstrated that the slow-release, polymer-based, paclitaxel-eluting stent reduces angiographic restenosis and the need for repeat revascularization procedures. Serial IVUS studies reveal details of the pattern of vascular responses provoked by stent implantation that provide insight into device safety and efficacy. METHODS: In the TAXUS-IV trial, patients were randomized to the slow-release, polymer-based, paclitaxel-eluting TAXUS stent or a bare-metal EXPRESS stent (Boston Scientific Corp., Natick, Massachusetts). As part of a formal substudy, complete volumetric IVUS data were available in 170 patients, including 88 TAXUS patients and 82 controls, at implantation and at nine-month follow-up. RESULTS: No baseline differences were present in the clinical characteristics or IVUS parameters between the control and TAXUS groups. At nine-month follow-up, IVUS lumen volumes were larger in the TAXUS group (123 +/- 43 mm(3) vs. 104 +/- 44 mm(3), p = 0.005), due to a reduction in neointimal volume (18 +/- 18 mm(3) vs. 41 +/- 23 mm(3), p < 0.001). Millimeter-by-millimeter analysis within the stent demonstrated uniform suppression of neointimal growth along the entire stent length. Late lumen loss was similar at the proximal edge of the stent between the two groups, and reduced with the TAXUS stent at the distal edge (p = 0.004). Incomplete stent apposition at nine months was observed in only 3.0% of control and 4.0% of TAXUS stents (p = 0.12). CONCLUSIONS: Polymer-based, paclitaxel-eluting TAXUS stents are effective in inhibiting neointimal tissue proliferation, and do not result in late incomplete stent apposition.

Antineoplastic Agents↗
PubMed2005

Cypher versus taxus: are there differences?

Today, drug-eluting stents (DES) are the standard stenting procedure in the USA and in Switzerland. The objective of this analysis is to answer the two questions: what clinically relevant data regarding DES have been published, and is there a clinically relevant difference between the Cypher and the Taxus stents? Twenty-two randomized, controlled studies with a total of 11,118 patients were identified: 18 randomized studies compared a DES to a bare metal stent of identical design in 8,301 patients, and 4 randomized studies compared the Cypher and the Taxus stents in 2,817 patients. Three studies regarding Paclitaxel-releasing stents without polymer (1,235 pats) and five studies regarding Paclitaxel released from a polymer (3,513 pats) were analyzed. Sirolimus released from a polymer was investigated in five studies (2,070 pats). Everolimus released from a polymer was investigated in three studies (166 pats), Biolimus A9 released from a polymer in one (120 pats), and Zotarolimus (ABT-578) released from a polymer in also one (1,197 pats) trial. Thirteen studies chose either a surrogate primary endpoint (angiographic or IVUS) or a clinical endpoint insufficient for a power calculation. A primary clinical endpoint with an adequate sample size for a power calculation was chosen in three trials for the Taxus stent (TAXUS-IV, TAXUS-V, TAXUS-VI; 2,916 patients), in one trial for the Cypher stent (SIRIUS; 1,058 patients), and in one trial for the Endeavor stent (ENDEAVOR-II; 1,197 patients). In all these trials, the primary clinical endpoint was reached. Of the four studies comparing Cypher stents to Taxus stents, one did not define the primary endpoint (TAXi), two assumed superiority of the Cypher stent (REALITY with a surrogate endpoint and SIRTAX, a single-center study), and one was designed as a non-inferiority trial (ISAR-Diabetes, single-center study with a surrogate endpoint). Based on the European Society of Cardiology established strict criteria with a clinical primary endpoint as a prerequisite to recommend a DES, only three DES have thus far had proven positive effects on clinical outcome: the Cypher-stents, Taxus-stents, and Endeavor-stents. A trial proving the superiority of one DES over another would require a multicenter study with a clinical primary endpoint at an adequate power. As long as such a trial does not exist, Cypher and Taxus are regarded as being equivalent.

Blood Vessel Prosthesis Implantation↗
PubMed1996

Taxol production in nodule cultures of Taxus.

The in vitro synthesis of secondary compounds from plants is one source of scarce and valuable phytopharmaceuticals. Often, some level of cellular or tissue differentiation is needed for the biosynthesis of many of these important compounds. Nodule cultures, consisting of cohesive multicellular units displaying a high degree of differentiation, were initiated from cultured needles of seven Taxus cultivars (Taxus cuspidata, Taxus x media 'Hicksii', Taxus x hunnewelliana 'Richard Horsey', Taxus x media 'Dark Green Spreader', Taxus x media 'L. C. Bobbick', and Taxus brevifolia). Under normal semicontinuous perfusion culture conditions (bimonthly refreshments to yield 0.2% sucrose), only trace amounts of taxol were detected from Taxus nodule cultures. However, with an elevated sucrose level (0.5% or 1.0%), taxol production was enhanced in T. cuspidata nodules to approximately 12 micrograms taxol/g nodule dry weight (dw). Stimulation of taxol production by elevated sucrose levels occurred even in the absence of other nutrients. The effect of increased sucrose on taxol induction does not appear to be due to an osmotic effect in the medium, suggesting that the increase in taxol production may be correlated with a metabolic process within the nodules. Although sucrose had a significant effect on taxol production, taxane precursors or elicitors of terpenes, as well as other plant secondary metabolites, had no effect on the production of taxol from these cultures. In addition to taxol, the higher sucrose levels also induced the production of 7-epi-10-deacetyltaxol, cephalomannine, and 7-epi-10-deacetylcephalomannine, so that total content of these taxanes equaled approximately 39 micrograms taxane/g dw nodules.

Culture Media↗
PubMed2004

[Structure and dynamics of Taxus chinensis var. mairei clonal population].

Structure and dynamics of Taxus chinensis var. mairei clonal population were studied. The results showed that according to the life history of Taxus chinensis var. mairei, the modular population could be divided into 6 classes. The development of Taxus chinensis var. mairei population was greatly depended on its ramets, which sprouted on its stem, and the population size structure was stable. The survival curve of Taxus chinensis var. mairei population showed a revered 'J' type. To expanding and continuing the population, there were high ramet sprouting rate and the resource limit induced a higher seedling and sapling mortality rate. When sapling grew up as young tree, its adventitious root stretched into soil to assimilate the nutrient and water, and it became independence individual. Before germination, the seed of Taxus need to dormant for more than one year, and the bird and beast liked to eat the seed, so it was hard to find seedling and sapling from seed. Therefore Taxus chinesis var. mairei had been considered to be a decline or none descendant population. In this study, it was found that Taxus chinensis var. mairei had a powerful asexual multiplication in Yuanbaoshan, especially ramet sprouting on stem. It was depend on this way to develop and expand the population.

Taxus↗