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Phase 3 Completed N=1,530 Randomized Single-blind Treatment

The PLATINUM Clinical Trial to Assess the PROMUS Element Stent System for Treatment of De Novo Coronary Artery Lesions

Source: ClinicalTrials.gov NCT00823212 ↗
Enrolled (actual)
1,530
Serious AEs
31.1%
Results posted
Jan 2012
Primary outcomePrimary: Target Lesion Failure (TLF) — 2.9; 3.4 percentage of participants — p=0.001

Summary

The purpose of this study is to evaluate the safety and effectiveness of the PROMUS Element™ Everolimus-Eluting Coronary Stent System for the treatment of patients with up to 2 de novo atherosclerotic coronary artery lesions. This clinical trial compares outcomes in patients treated with PROMUS Element to those in patients treated with a different everolimus-eluting coronary stent. The lesions are of average length in average-sized vessels ("workhorse"). A companion sub-trial evaluates outcomes in smaller vessels (SV) and another sub-trial evaluates outcomes in longer lesions (LL).

Outcome Measures

OutcomeResultp-value
PRIMARY
Target Lesion Failure (TLF)
3.2; 3.5
SECONDARY
Target Lesion Failure (TLF)
3.2; 3.5
SECONDARY
Target Lesion Failure (TLF)
3.2; 3.5
SECONDARY
Target Lesion Failure (TLF)
3.2; 3.5
SECONDARY
Target Vessel Failure (TVF)
4.0; 4.2
SECONDARY
Target Vessel Failure (TVF)
4.0; 4.2
SECONDARY
Target Vessel Failure (TVF)
4.0; 4.2
SECONDARY
Myocardial Infarction (MI) Related to the Target Vessel
1.4; 0.7
SECONDARY
Myocardial Infarction (MI) Related to the Target Vessel
1.4; 0.7
SECONDARY
Myocardial Infarction (MI) Related to the Target Vessel
1.4; 0.7
SECONDARY
All Cause Mortality
1.2; 1.3
SECONDARY
All Cause Mortality
1.2; 1.3
SECONDARY
All Cause Mortality
1.2; 1.3
SECONDARY
Cardiac Death Related to the Target Vessel
0.4; 0.8
SECONDARY
Cardiac Death Related to the Target Vessel
0.4; 0.8
SECONDARY
Cardiac Death Related to the Target Vessel
0.4; 0.8
SECONDARY
Non-cardiac Death
0.5; 0.4
SECONDARY
Non-cardiac Death
0.5; 0.4
SECONDARY
Non-cardiac Death
0.5; 0.4
SECONDARY
Cardiac Death or Myocardial Infarction (MI)
2.5; 2.0
SECONDARY
Cardiac Death or Myocardial Infarction (MI)
2.5; 2.0
SECONDARY
Cardiac Death or Myocardial Infarction (MI)
2.5; 2.0
SECONDARY
All Death or Myocardial Infarction (MI)
3.0; 2.4
SECONDARY
All Death or Myocardial Infarction (MI)
3.0; 2.4
SECONDARY
All Death or Myocardial Infarction (MI)
3.0; 2.4
SECONDARY
Target Lesion Revascularization (TLR)
1.9; 1.9
SECONDARY
Target Lesion Revascularization (TLR)
1.9; 1.9
SECONDARY
Target Lesion Revascularization (TLR)
1.9; 1.9
SECONDARY
Target Vessel Revascularization (TVR)
2.9; 2.7
SECONDARY
Target Vessel Revascularization (TVR)
2.9; 2.7
SECONDARY
Target Vessel Revascularization (TVR)
2.9; 2.7
SECONDARY
Definite + Probable Stent Thrombosis (ST) Rate Based on Academic Research Consortium (ARC) Definition
0.0; 0.3
SECONDARY
Definite + Probable Stent Thrombosis (ST) Rate Based on Academic Research Consortium (ARC) Definition
0.0; 0.3
SECONDARY
Definite + Probable Stent Thrombosis (ST) Rate Based on Academic Research Consortium (ARC) Definition
0.0; 0.3
SECONDARY
Composite of All Death, All Myocardial Infarction (MI), All Target Vessel Revascularization (TVR)
4.9; 5.0
SECONDARY
Composite of All Death, All Myocardial Infarction (MI), All Target Vessel Revascularization (TVR)
4.9; 5.0
SECONDARY
Composite of All Death, All Myocardial Infarction (MI), All Target Vessel Revascularization (TVR)
4.9; 5.0
SECONDARY
Clinical Procedural Success
98.2; 98.3
SECONDARY
Acute Technical Success
98.8; 99.4

Eligibility Criteria

Inclusion Criteria

  • Patient must be at least 18 years of age
  • Patient (or legal guardian) understands study requirements and treatment procedures and provides written informed consent before any study-specific tests or procedures are performed
  • For patients less than 20 years of age enrolled at a Japanese site, patient and patient's legal representative must provide written informed consent before any study-specific tests or procedures are performed
  • Patient is eligible for percutaneous coronary intervention (PCI)
  • Patient has documented stable angina pectoris or documented silent ischemia; or unstable angina pectoris
  • Patient is an acceptable candidate for coronary artery bypass grafting (CABG)
  • Patient has a left ventricular ejection fraction (LVEF) >=30% as measured within 30 days prior to enrollment
  • Patient is willing to comply with all protocol-required follow-up evaluations

Angiographic Inclusion Criteria (visual estimate):

  • Target lesion must be a de novo lesion located in a native coronary artery with a visually estimated reference vessel diameter (RVD) >=2.50 mm and =50% and 1.

Exclusion Criteria

  • Patient has clinical symptoms and/or electrocardiogram (ECG) changes consistent with acute myocardial infarction (MI)
  • Patient has had a known diagnosis of recent MI (ie, within 72 hours prior to index procedure) and has elevated enzymes at time of index procedure as follows.
  • Patients are excluded if any of the following criteria are met at time of the index procedure.
  • If creatine kinase-myoglobin band (CK-MB) >2× upper limit of normal (ULN), the patient is excluded regardless of CK Total.
  • If CK-MB is 1-2× ULN, the patient is excluded if the CK Total is >2× ULN.
  • If CK Total/CK MB are not used and Troponin is, patients are excluded if the following criterion is met at time of index procedure.
  • Troponin >1× ULN with at least one of the following.
  • Patient has ischemic symptoms and ECG changes indicative of ongoing ischemia (eg, >1 mm ST segment elevation or depression in consecutive leads or new left bundle branch block [LBBB]);
  • Development of pathological Q waves in the ECG; or
  • Imaging evidence of new loss of viable myocardium or new regional wall motion abnormality.

Note: For patients with unstable angina or patients who have had a recent MI, CK Total/CK MB (or Troponin if CK Total/CK MB are not used) must be documented prior to enrolling/randomizing the patient.

  • Patient has received an organ transplant or is on a waiting list for an organ transplant
  • Patient is receiving or scheduled to receive chemotherapy within 30 days before or after index procedure
  • Patient is receiving oral or intravenous immunosuppressive therapy (ie, inhaled steroids are not excluded) or has known life-limiting immunosuppressive or autoimmune disease (eg, human immunodeficiency virus, systemic lupus erythematosus, but not including diabetes mellitus)
  • Patient is receiving chronic (>=72 hours) anticoagulation therapy (eg, heparin, coumadin) for indications other than acute coronary syndrome
  • Patient has platelet count 700,000 cells/mm3
  • Patient has white blood cell (WBC) count =2.0 mm in diameter by visual estimate
  • Involves a clinically significant side branch 50% diameter stenosis)
  • Patient has protected left main coronary artery disease and a target lesion in the LAD or LCX
  • Patient has an additional clinically significant lesion(s) in target vessel for which an intervention within 12 months after the index procedure is likely to be required
  • Patient has 2 target lesions in the same vessel that are separated by less than 15 mm (by visual estimate) Note: Multiple focal stenoses will be considered as a single lesion if they can be completely covered with 1 stent.
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT00823212). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication. Informational only — not medical advice.

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