4.3 Article

Five-Year Clinical Follow-Up of a Randomized Comparison of a Polymer-Free Sirolimus-Eluting Stent versus a Polymer-Based Paclitaxel-Eluting Stent in Patients with Diabetes Mellitus (LIPSIA Yukon Trial)

Journal

CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS
Volume 83, Issue 3, Pages 418-424

Publisher

WILEY-BLACKWELL
DOI: 10.1002/ccd.25131

Keywords

coronary artery disease; drug-eluting stent; paclitaxel; sirolimus; polymer-free

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ObjectivesThe long-term performance of polymer-free stent systems in patients with diabetes mellitus has not been investigated extensively. This study reports long-term results of the LIPSIA Yukon trial which compared the polymer-free sirolimus-eluting Yukon Choice stent with the polymer-based paclitaxel-eluting Taxus Liberte stent in this subpopulation. At 9 months, the Yukon Choice stent failed to show non-inferiority in terms of the primary end point late lumen loss, while no significant difference in clinical outcome was detected. Methods and ResultsThe LIPSIA Yukon trial randomized 240 patients with diabetes mellitus to a polymer-free sirolimus eluting stent (Yukon Choice, Translumina) versus a polymer-based paclitaxel-eluting stent (Taxus Liberte, Boston Scientific). Clinical follow-up was conducted with a standardized telephone follow-up and all events were centrally adjudicated. Follow-up was available for 98.3% of patients after a median of 5.0 years. The incidence of all-cause death (16.9% versus 14.0%, P=0.67), respectively definite or presumed cardiovascular death (7.6% versus 8.8%, P=0.94) were similar in the Yukon Choice and the Taxus Liberte group. There were no significant differences in the rates of myocardial infarction (9.3% versus 7.9%, P=0.88), definite stent thrombosis (0.8% versus 0.9%, P=1.0), target lesion revascularization (15.3% versus 15.8%, P=1.0), target vessel revascularization (18.6% versus 23.7%, P=0.44), non-target vessel revascularization (18.6% versus 26.3%, P=0.21), and stroke (3.4% versus 4.4%, P=0.96) between patients assigned to the Yukon Choice and the Taxus Liberte stent. ConclusionAt 5 years of follow-up, clinical outcome was similar between the polymer-free sirolimus-eluting Yukon Choice stent and the polymer-based paclitaxel-eluting Taxus Liberte stent. (c) 2013 Wiley Periodicals, Inc.

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