Gao Runlin, Han Yaling, Yang Yuejin, Zhang Jian, Hou Yuqing, Wang Haichang, Li Hui, Fang Quan, Yu Bo, Xu Bo, Allocco Dominic J, Dawkins Keith D
Department of Cardiology, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Catheter Cardiovasc Interv. 2015 Mar;85 Suppl 1:716-23. doi: 10.1002/ccd.25859. Epub 2015 Feb 18.
The PLATINUM China clinical trial evaluated the safety and effectiveness of the thin-strut, everolimus-eluting, platinum-chromium PROMUS™ Element™ stent (PtCr-EES) (Boston Scientific, Marlborough, MA) for the treatment of patients in China.
Clinical outcomes from the PtCr-EES have not been evaluated in patients from China, nor has it been directly compared with the second-generation stainless steel paclitaxel-eluting TAXUS Liberté stent (PES) in a randomized head-to-head trial. Methods In this prospective, multicenter, single-blind, superiority trial, patients with a single de novo atherosclerotic coronary artery lesion were randomized 1:3 to receive either the PES or PtCr-EES. The primary endpoint was in-stent late loss at 9 months.
Among 127 PES and 373 PtCr-EES patients (71.2% male; mean age 57.3 years), the primary endpoint of 9-month in-stent late loss was 0.40 ± 0.45 mm for PES versus 0.11 ± 0.36 mm for PtCr-EES (P < 0.001). In-stent % diameter stenosis was 22.20 ± 16.00% for PES versus 11.06 ± 13.86% for PtCr-EES (P < 0.001) at 9 months. The 1-year rate of death/MI was 1.6% (2/127) for PES versus 0% (0/371) for PtCr-EES (P = 0.06) and target vessel revascularization was 4.7% (6/127) for PES versus 2.7% (10/371) for PtCr-EES (P = 0.26). No stent thromboses occurred at 12 months in either group.
In the largest prospective angiographic evaluation conducted to date with this stent, the PROMUS Element PtCr-EES was superior to the TAXUS Liberté PES for the primary endpoint of late loss at 9 months, with low rates of clinical events at 1 year. Clinical follow-up will continue to 2 years.
PLATINUM中国临床试验评估了薄支柱、依维莫司洗脱、铂铬材质的PROMUS™ Element™支架(PtCr-EES)(波士顿科学公司,马尔伯勒,马萨诸塞州)在中国患者治疗中的安全性和有效性。
尚未在中国患者中评估PtCr-EES的临床疗效,也未在随机头对头试验中直接将其与第二代不锈钢紫杉醇洗脱TAXUS Liberté支架(PES)进行比较。方法 在这项前瞻性、多中心、单盲、优效性试验中,将患有单一新发动脉粥样硬化性冠状动脉病变的患者按1:3随机分组,分别接受PES或PtCr-EES治疗。主要终点是9个月时的支架内晚期管腔丢失。
在127例接受PES治疗的患者和373例接受PtCr-EES治疗的患者中(男性占71.2%;平均年龄57.3岁),PES组9个月时支架内晚期管腔丢失的主要终点为0.40±0.45 mm,而PtCr-EES组为0.11±0.36 mm(P<0.001)。9个月时,PES组的支架内直径狭窄百分比为22.20±16.00%,而PtCr-EES组为11.06±13.86%(P<0.001)。PES组1年的死亡/心肌梗死发生率为1.6%(2/127),而PtCr-EES组为0%(0/371)(P=0.06),PES组的靶血管血运重建率为4.7%(6/127),而PtCr-EES组为2.7%(10/371)(P=0.26)。两组在12个月时均未发生支架内血栓形成。
在迄今为止对该支架进行的最大规模前瞻性血管造影评估中,PROMUS Element PtCr-EES在9个月晚期管腔丢失这一主要终点方面优于TAXUS Liberté PES,且1年时临床事件发生率较低。临床随访将持续至2年。