Brazilian and Italian Evaluation of Safety Using Tacrolimus-eluting Stent With Short-term Dual Antiplatelet Regimen (BEST)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT01122719
Recruitment Status : Terminated (slow inclusion, due to difficulties in obtaining the patients consent for the 2 months invasive follow-up, as required by protocol design.)
First Posted : May 13, 2010
Last Update Posted : May 7, 2018
Contract research Organization: Cardiovascular Research Center - Sao Paulo, Brazil
Information provided by (Responsible Party):
CID - Carbostent & Implantable Devices

May 11, 2010
May 13, 2010
May 7, 2018
October 2010
November 2011   (Final data collection date for primary outcome measure)
In-stent late lumen loss [ Time Frame: 8-month ]
Same as current
Complete list of historical versions of study NCT01122719 on Archive Site
  • All-cause and cardiac mortality; [ Time Frame: up to 24 months ]
  • Myocardial infarction (MI): Q-wave and non-Q-wave, cumulative and individual [ Time Frame: up to 24 months ]
  • Major Adverse Cardiac Event (MACE) defined as a composite of cardiac death, MI (Q wave or non-Q wave), emergent coronary artery bypass surgery (CABG), or target lesion revascularization (TLR) by repeat PTCA or CABG [ Time Frame: up to 24 months ]
  • Rate of stent thrombosis using ARC definition of definite and probable stent thrombosis and categorized as early, late or very late [ Time Frame: up to 24 months ]
  • Stent strut coverage assessed by OCT [ Time Frame: 2 months ]
  • Late acquired incomplete stent apposition by IVUS [ Time Frame: 8-month ]
  • In stent & In segment angiographic parameters [ Time Frame: 8-month ]
  • Clinically Driven TLR [ Time Frame: up to 24 months ]
  • Clinically Driven TVR [ Time Frame: up to 24 months ]
  • Target Lesion Failure (TLF) defined as cardiac death, MI and ischemic Target Lesion Revascularization (TLR) [ Time Frame: up to 24 months ]
Same as current
Not Provided
Not Provided
Brazilian and Italian Evaluation of Safety Using Tacrolimus-eluting Stent With Short-term Dual Antiplatelet Regimen
The Best Trial - Brazilian and Italian Evaluation of Safety Using Tacrolimus-eluting Stent With Short-term Dual Antiplatelet Regimen
To evaluate the safety and efficacy of the Janus OPTIMA Tacrolimus-Eluting Stent (Optima TES, CID) for the treatment of de novo coronary lesions when associated with short-term (two months) dual antiplatelet (aspirin + clopidogrel) regimen.

The present study is a post-market, prospective, international, two-center, single arm study involving 60 patients with single, de novo non-complex coronary lesions.

Enrolled patients will be asked to return for follow-up clinical evaluation at 1, 6, 12 and 24 months. At 3 months there will be an additional follow-up by phone contact.

Furthermore, the first 15 patients should undergo angiographic and OCT follow-up at two months. The remaining 45 patients should undergo angiographic and IVUS follow-up at 8 months.

Not Applicable
Allocation: Non-Randomized
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
  • Stable Coronary Disease
  • Unstable Coronary Disease
  • Documented Silent Ischemia
Device: Drug Eluting Stent
Not Provided
Not Provided

*   Includes publications given by the data provider as well as publications identified by Identifier (NCT Number) in Medline.
March 2013
November 2011   (Final data collection date for primary outcome measure)

Inclusion Criteria:

  • Patient with >18 years of age;
  • Symptoms of stable or unstable angina and/or presence of a positive functional test for ischemia;
  • Presence of a single de novo target lesion located in a native coronary vessel suitable for percutaneous treatment with the study stents;
  • Acceptable candidate for coronary artery bypass graft(CABG)surgery;
  • The subject is willing to sign a written informed consent prior to procedure, and is willing to undergo ALL study protocol follow-ups,including angiographic, IVUS and OCT assessments.
  • Single, de novo lesion
  • Target lesion located in a major epicardial coronary vessel with reference of 2.5-3.5mm in diameter (by on-line QCA)
  • Target lesions ≤19mm in length (by visual estimation) that can be treated (covered) by one single study stent (19 or 24mm in length);
  • ≥50% and <100% diameter stenosis;
  • TIMI (Thrombolysis In Myocardial Infarction) flow grade ≥2.

Exclusion Criteria:

  • Known hypersensitivity or contraindication to tacrolimus, heparin,any required medications including thienopyridines, and contrast media which cannot be adequately pre medicated;
  • Patient is a female with childbearing potential;
  • Pre-treatment of the target lesion with any devices other than balloon angioplasty;
  • Previous brachytherapy in the target vessel;
  • Presence of non-target vessel lesions which require staged procedure(s) <30 days of the index procedure;
  • Prior CABG surgery to target vessel;
  • Previous percutaneous coronary intervention (PCI) or CABG surgery <30 days to the index procedure date;
  • Acute myocardial infarction <3 days, with cardiac enzyme elevation including total creatine kinase (CK) >2 times the upper normal limit value and/or CK-MB above the upper normal limit value within the past 72 hours;
  • CK and/or CK-MB levels elevated above the upper normal limit value at the time of the index procedure;
  • Documented left ventricular ejection fraction <30%;
  • Renal insufficiency determined by a baseline serum creatinine >2.0 mg/dl;
  • Thrombocytopenia with a baseline platelet count <100,000 cells/mm3;
  • Anemia with baseline hemoglobin <10g/dL;
  • Extensive peripheral vascular disease or extreme anticoagulation that precludes safe >5 French sheath insertion;
  • History of bleeding diathesis, coagulopathy, or refusal of blood transfusions;
  • Patients has suffered a stroke, transient ischemic attack (TIA),or cerebrovascular accident (CVA) within the past 6 months;
  • Significant gastrointestinal or genitourinary bleed within the past 6 months;
  • Patient is a recipient of a heart transplant;
  • Any elective surgical procedure is planned within 12 months of the index procedure;
  • Known illness or any serious clinical condition with life expectancy <2 years;
  • Participation in the active or follow-up phase of any other clinicaltrial within 6 months;
  • Impossibility to comply with anti-platelet therapy during the study clinical follow-up;
  • Any impossibility to comply with all protocol follow-ups.
  • Target lesion or vessel with angiographic evidence of moderate or severe calcification;
  • Presence of severe tortuosity;
  • Presence of severe angulation (>60o);
  • Presence of intraluminal thrombus;
  • Target lesion involving a bifurcation (side branch ≥2.0mm);
  • Target lesion located in the left main stem;
  • Aorto-ostial lesion location;
  • Target lesion involving a side branch with reference diameter≥2.0mm;
  • Presence of a significant stenosis (>40%) in the target vessel either proximal or distal to the target lesion that will be untreated;
  • Previous placement of a stent within 10mm of the target lesion;
  • Total occlusion (TIMI flow grade 0 or 1);
  • Target lesion located in an arterial or vein graft;
  • Target lesion due to in-stent restenosis;
  • Coronary anatomy unsuitable for percutaneous treatment with implantation of the available study stents.
Sexes Eligible for Study: All
18 Years and older   (Adult, Senior)
Contact information is only displayed when the study is recruiting subjects
Brazil,   Italy
Not Provided
Not Provided
CID - Carbostent & Implantable Devices
CID - Carbostent & Implantable Devices
Contract research Organization: Cardiovascular Research Center - Sao Paulo, Brazil
Principal Investigator: Marco Valgimigli, Dr Azienda Ospedaliero Universitaria di Ferrara - Italy
Principal Investigator: Alexandre Abizaid, Dr Instituto Dante Pazzanese de Cardiologia
CID - Carbostent & Implantable Devices
May 2018

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP