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The Super Bowl of Stents

Get ready for the next drug-coated stent showdown, which starts Sunday at the annual American College of Cardiology conference in Orlando, Fla.

The main event will be the results of a head-to-head -- or artery-to-artery -- test comparing the Cypher stent from Johnson & Johnson (JNJ) versus the Taxus stent from Boston Scientific (BSX).

Another big attraction features research comparing Medtronic's (MDT) experimental Endeavor drug-coated stent with an uncoated Medtronic stent.

The stakes are big for all three companies. J&J hopes a company-financed study will help convince cardiologists to switch to Cypher from Taxus, which entered the market in March 2004, 11 months after Cypher.

Boston Scientific has shrugged off a stent recall this summer to retain its dominant position. The companies don't agree on market-share figures, but roughly speaking, Taxus has about a 2-to-1 edge.

Medtronic is hoping that its Endeavor test will provide enough compelling information to gain an accelerated review by the Food and Drug Administration. To many analysts, these results will indicate whether the company's stent enters the U.S. market in 2006 or 2007.

Every minute counts because Guidant (GDT), which is being acquired by J&J, and Abbott Laboratories (ABT) also are working on drug-coated stents.

Drug-coated stents are meshlike metal tubes inserted into arteries after vessel-clogging plaque has been removed. The stents facilitate blood flow and reduce the risk of heart attack. The drug-coated stents, also known as drug-eluting stents, release chemicals into the arteries periodically to reduce the risk of arteries reclogging. Uncoated stents reduce the reclogging risk, too, but the drug-coated devices do a better job.

The Cypher versus Taxus performance will be unveiled via a J&J-sponsored test nicknamed Reality. "Even if the data revealed slightly more favorable, non-significant trends for Cypher, the difference ... is likely not enough to induce a material shift away from Taxus use," said a recent research report from Goldman Sachs. And if Cypher's results appeared slightly better, "Taxus use is likely to be dictated more so by the delivery/flexibility" of the Taxus delivery system.

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