Phase 3
Completed N=1,530
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
| Outcome | Result | p-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.
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.