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.
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.