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Clinical research

Direct stenting of de novo coronary stenoses with tacrolimus-eluting versus carbon-coated carbostents. The randomized JUPITER II trial

1. Institut Jacques Cartier, Massy, France; 2. Herz-Zentrum Bad Krozingen, Bad Krozingen, Germany; 3. Hôpital de Rangueil, Toulouse, France; 4. Hospital Clinico San Carlos, Madrid, Spain; 5. University Medical Center Radboud, Nijmegen, The Netherlands; 6. Cardiovascular Centre Aalst, Belgium; 7. University Hospital Gasthuisberg, Leuven, Belgium; 8. Academic Medical Center, Amsterdam, The Netherlands; 9. A.Z. Middelheim, Antwerp, Belgium; 10. Vivantes Friedrichshain/Urban, Berlin, Germany; 11. University of Innsbruck, Innsbruck, Austria; 12. Royal Brompton Hospital, London, United Kingdom

Aims: Drug-eluting stents are being increasingly used for the treatment of de novo coronary lesions. This trial compared the performance of tacrolimus-eluting stents (TES) with that of equivalent carbon-coated stents (CCS).

Methods and results: The JUPITER II trial enrolled 332 patients (mean age = 64 years, 75% men) with de novo coronary stenoses. Patients were randomly assigned to TES versus CCS and underwent repeat coronary angiography at 6 months. The primary study endpoint was in-stent and in-segment late lumen loss (LLL). The main secondary endpoints included binary restenosis, and rates of major adverse clinical events (MACE), including death, myocardial infarction, target lesion revascularisation and stent thrombosis at 1, 6, and 12 months of follow-up. The procedure was successful in 99.4% of patients in both groups. There was no procedural death, 1 cardiac death at 2 months, and 1 acute and 2 subacute CCS thromboses. Angiographic follow-ups were available in 94.4% and 95.1% of patients assigned to TES and CCS, respectively. The mean in-segment and in-stent LLL was 0.42±0.46 mm and 0.65±0.47 mm, respectively, in the TES, versus 0.48±0.52 mm and 0.66±0.53 mm, respectively, in the CCS group (ns). The 12-month cumulative MACE rate was 19.5% in the CCS versus 16.1% in the TES group (ns).

Conclusions: Both stents showed high safety, with no stent thrombosis in the TES group. No difference was observed in 6-month angiographic results and 12-month MACE rates between TES and CCS.

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