Five-Year PLATINUM Results Published for Boston Scientific's Promus Element EES

 

December 18, 2017—Five-year results from the multicenter, randomized PLATINUM trial were published by Christopher R. Kelly, MD, et al in Journal of the American College of Cardiology (JACC): Cardiovascular Interventions (2017;10:2392–2400). PLATINUM assessed the Promus Element platinum-chromium everolimus-eluting stent (PtCr-EES; Boston Scientific Corporation) for treatment of de novo coronary artery lesions.

The investigators evaluated the final 5-year safety and effectiveness of the Promus Element PtCr-EES compared with a cobalt-chromium EES (CoCr-EES). At 1 year in the PLATINUM study, the PtCr-EES demonstrated noninferiority to the CoCr-EES in 1,530 patients undergoing percutaneous coronary intervention.

The investigators also reported on two single-arm substudies that evaluated the PtCr-EES in small vessels (diameter < 2.5 mm; n = 94) and long lesions (diameter, 24–34 mm; n = 102).

As summarized in JACC: Cardiovascular Interventions, patients with one or two de novo coronary artery lesions (reference vessel diameter, 2.5–4.25 mm, length ≤ 24 mm) were randomized 1:1 to PtCr-EES or CoCr-EES. All patients in the substudies received PtCr-EES. The primary endpoint was target lesion failure (TLF), a composite of target vessel–related cardiac death, target vessel–related myocardial infarction, or ischemia-driven target lesion revascularization.

The 5-year TLF rate was 9.1% for the PtCr-EES and 9.3% for the CoCr-EES (hazard ratio [HR], 0.97; P = .87). Landmark analysis demonstrated similar TLF rates from discharge to 1 year (HR, 1.12; P = .7) and from 1 to 5 years (HR, 0.9; P = .63). There were no significant differences in the rates of cardiac death, myocardial infarction, target lesion or vessel revascularization, or stent thrombosis. The PtCr-EES had 5-year TLF rates of 7% in small vessels and 13.6% in long lesions.

The PtCr-EES demonstrated comparable safety and effectiveness to the CoCr-EES through 5 years of follow-up, with low rates of stent thrombosis and other adverse events. The 5-year event rates were also acceptable in patients with small vessels and long lesions treated with the PtCr-EES, concluded the investigators in JACC: Cardiovascular Interventions.

 

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Cardiac Interventions Today (ISSN 2572-5955 print and ISSN 2572-5963 online) is a publication dedicated to providing comprehensive coverage of the latest developments in technology, techniques, clinical studies, and regulatory and reimbursement issues in the field of coronary and cardiac interventions. Cardiac Interventions Today premiered in March 2007 and each edition contains a variety of topics in a flexible format, including articles covering various perspectives on current clinical topics, in-depth interviews with expert physicians, overviews of available technologies, industry news, and insights into the issues affecting today's interventional cardiology practices.