Randomized Comparison of a Polymer-Free Sirolimus-Eluting Stent Versus a Polymer-Based Paclitaxel-Eluting Stent in Patients With Diabetes Mellitus The LIPSIA Yukon Trial

Objectives The objective of the study was to assess noninferiority of the polymer-free sirolimus-eluting Yukon Choice stent (Translumina GmbH, Hechingen, Germany) compared with the polymer-based Taxus Liberte stent (Boston Scientific, Natick, Massachusetts) with regard to the primary end-point, in-stent late lumen loss, at 9 months in patients with diabetes mellitus. Background The Yukon Choice stent has been evaluated in several randomized controlled trials before, albeit to date, there has been no trial that exclusively enrolled patients with diabetes mellitus. Methods Patients with diabetes mellitus undergoing percutaneous coronary intervention for clinically significant de novo coronary artery stenosis were randomized 1:1 to receive either the polymer-free sirolimus-eluting Yukon Choice stent or the polymer-based paclitaxel-eluting Taxus Liberte stent. Results A total of 240 patients were randomized. Quantitative coronary angiography was available for 79% of patients. Mean in-stent late lumen loss was 0.63 +/- 0.62 mm for the Yukon Choice stent and 0.45 +/- 0.60 mm for the Taxus Liberte stent. Based on the pre-specified margin, the Yukon Choice stent failed to show noninferiority for the primary endpoint. During follow-up, there were no significant differences between groups regarding death, myocardial infarction, stent thrombosis, target lesion revascularization, target vessel revascularization, or nontarget vessel revascularization. Conclusions Compared with the Taxus Liberte stent, the polymer-free sirolimus-eluting Yukon Choice stent failed to show noninferiority with regard to the primary endpoint, in-stent late lumen loss, in patients with diabetes mellitus after 9-month follow-up. Both stents showed comparable clinical efficacy and safety. (Yukon Choice Versus Taxus Liberte in Diabetes Mellitus; NCT00368953) (J Am Coll Cardiol Intv 2011;4:452-9) (C) 2011 by the American College of Cardiology Foundation