Key result
Implantation of the polymer-free sirolimus-eluting YUKON-DES was associated with a 5-year MACE rate of 14.8% for on-label versus 40.8% for off-label indications (P<0.001).
Cohort (n=701)
Polymer-free sirolimus-eluting stents demonstrate long-term safety and feasibility with low rates of stent thrombosis at 5 years in a real-world cohort.
Off-label YUKON-DES use warrants caution given higher MACE; extends real-world data but leaves open need for randomized confirmation.
OBJECTIVES: Drug-eluting stents (DES) constitute a major achievement in preventing re-stenosis, concerns remain regarding the increased inflammatory responses associated with the polymers used. This analysis focuses on outcomes in patients receiving the polymer-free sirolimus-eluting stent system YUKON-Choice (Yukon-DES, Translumina, Germany). METHODS: From 01/2006-09/2008 all patients receiving Yukon-DES (≥2.5 mm diameter) were prospectively enrolled in our registry. The primary endpoint was long-term major adverse cardiac events (MACE). RESULTS: 701 patients were included in our registry. Mean age was 65.7 ± 10 years (73% male gender, 35.5% diabetes, and 32.2% acute coronary syndrome). 76% of the lesions were of Type B2/C. Lesion length was 24.6 ± 5.2 mm and mean stent diameter was 2.8 ± 0.4 mm. A total of 511 pts (72%) underwent 6-months angiographic follow-up, target vessel revascularization was noted in 23.5%. At 5 years clinical outcomes were: cardiac death 5.8%; myocardial infarction 3.4%; and TVR 24.6%. The incidence of MACE differed significantly between "on-label" and "off-label" indications (14.8% vs. 40.8% MACE; P < 0.001). Incidence of definitive/probable stent thrombosis (ST) was 1.14% (8/701); very late (>1 year) ST occurred in 0.29%. CONCLUSION: Our data suggests that the implantation of the sirolimus-coated polymer-free YUKON-DES is safe and feasible with a very low incidence of ST in this real world patient cohort with high percentage of diabetes and small vessels.
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Ohlow et al. (2013) conducted a cohort in Coronary artery disease (n=701). Polymer-free sirolimus-eluting stent system YUKON-Choice was evaluated on long-term major adverse cardiac events (MACE). Implantation of the polymer-free sirolimus-eluting YUKON-DES was associated with a 5-year MACE rate of 14.8% for on-label versus 40.8% for off-label indications (P<0.001).
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