Small-vessel PCI outcomes in men, women, and minorities following platinum chromium everolimus-eluting stents: Insights from the pooled PLATINUM Diversity and PROMUS Element Plus Post-Approval studies

Paul Guedeney, Bimmer E. Claessen, Roxana Mehran, David E. Kandzari, Melissa Aquino, Scott Davis, Luis Tamis, John C. Wang, Islam Othman, Osvaldo S. Gigliotti, Amir Haghighat, Sarabjeet Singh, Mario Lopez, Gregory Giugliano, Phillip A. Horwitz, Sabato Sorrentino, Paul Underwood, Dominic Allocco, Ian T. Meredith, Wayne Batchelor

Research output: Contribution to JournalArticleAcademicpeer-review

5 Citations (Scopus)

Abstract

Objective: We evaluated 1-year outcomes after platinum chromium everolimus-eluting stents (PtCr-EES) in small versus non-small coronary arteries within a large, diverse sample of men, women, and minorities. Background: There exists limited outcomes data on the use of second-generation drug-eluting stent to treat small diameter coronary arteries. Methods: We pooled patients from the PLATINUM Diversity and PROMUS Element Plus stent registries. Small-vessel percutaneous coronary intervention (SV-PCI) was defined as ≥1 target lesion with reference vessel diameter (RVD) ≤2.5 mm. Endpoints included major adverse cardiac event (MACE; death, myocardial infarction [MI] or target vessel revascularization [TVR]), target vessel failure (TVF; death related to the target vessel, target vessel MI or TVR) and definite/probable stent thrombosis (ST). Multivariable Cox regression was used to risk-adjust outcomes. Results: We included 4,155/4,182 (99%) patients with available RVD, of which 1,607 (39%) underwent small-vessel PCI. SV-PCI was not associated with increased MACE (adjHR 1.02; 95%CI 0.81–1.30) or TVF (adjHR 1.07; 95%CI 0.82–1.39). MI risk was lower in white men compared to women and minorities, both in the setting of SV-PCI (adjHR 0.41; 95%CI 0.23–0.74 and adjHR 0.39; 95%CI 0.20–0.75, respectively) and for non-SV-PCI (adjHR 0.61; 95%CI 0.38–0.99 and adjHR 0.45; 95%CI 0.27–0.74, respectively). There was no significant interaction between RVD and sex or minority status for any endpoint. Conclusion: In a large diverse contemporary PCI outcomes database, SV-PCI with PtCr-EES was not associated with increased MACE or TVR and did not account for the increased MI risk noted in women and minorities compared to white men.

Original languageEnglish
Pages (from-to)82-90
Number of pages9
JournalCatheterization and cardiovascular interventions
Volume94
Issue number1
DOIs
Publication statusPublished - 1 Jul 2019

Keywords

  • coronary artery disease
  • drug-eluting stent
  • percutaneous coronary intervention
  • platinum chromium everolimus-eluting stent
  • small coronary artery vessel
  • women and minority

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