Outcomes of the Novel Supreme Drug-Eluting Stent in Complex Coronary Lesions: A PIONEER III Substudy

Kush P. Patel, MBBS; Alexandra J. Lansky, MD; Dean J. Kereiakes, MD; Stephan Windecker, MD; Ecaterina Cristea, MD; Cody Pietras, BA; Ovidiu Dressler, MD; M. Ozgu Issever, MS; Michael Curtis, MD; Barry Bertolet, MD; James P. Zidar, MD; Pieter C. Smits, MD; Victor Alfonso Jiménez Díaz, MD; Brent McLaurin, MD; David A. Brogno, MD; Luc Janssens, MD; Mathias C. Vrolix, MD; Iván Gómez-Blázquez, MD; Zakir H. Sahul, MD; Ameer Kabour, MD; Luisa Salido, MD; Michael Cleman, MD; Shigeru Saito, MD; Martin B. Leon, MD; Andreas Baumbach, MD

Journal of the Society for Cardiovascular Angiography & Interventions (Jan 2022)

Outcomes of the Novel Supreme Drug-Eluting Stent in Complex Coronary Lesions: A PIONEER III Substudy

Kush P. Patel, MBBS,
Alexandra J. Lansky, MD,
Dean J. Kereiakes, MD,
Stephan Windecker, MD,
Ecaterina Cristea, MD,
Cody Pietras, BA,
Ovidiu Dressler, MD,
M. Ozgu Issever, MS,
Michael Curtis, MD,
Barry Bertolet, MD,
James P. Zidar, MD,
Pieter C. Smits, MD,
Victor Alfonso Jiménez Díaz, MD,
Brent McLaurin, MD,
David A. Brogno, MD,
Luc Janssens, MD,
Mathias C. Vrolix, MD,
Iván Gómez-Blázquez, MD,
Zakir H. Sahul, MD,
Ameer Kabour, MD,
Luisa Salido, MD,
Michael Cleman, MD,
Shigeru Saito, MD,
Martin B. Leon, MD,
Andreas Baumbach, MD

Affiliations

Kush P. Patel, MBBS: Institute of Cardiovascular Science, University College London, London, UK; Barts Heart Centre, London, UK
Alexandra J. Lansky, MD: Division of Cardiology, Yale School of Medicine, New Haven, Connecticut; Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University of London, London, UK
Dean J. Kereiakes, MD: The Christ Hospital and the Lindner Research Center, Cincinnati, Ohio
Stephan Windecker, MD: Department of Cardiology, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland
Ecaterina Cristea, MD: Division of Cardiology, Yale School of Medicine, New Haven, Connecticut
Cody Pietras, BA: Division of Cardiology, Yale School of Medicine, New Haven, Connecticut
Ovidiu Dressler, MD: Cardivascular Research Foundation, New York, New York
M. Ozgu Issever, MS: Cardivascular Research Foundation, New York, New York
Michael Curtis, MD: University of Calgary, Calgary, Alberta, Canada
Barry Bertolet, MD: Cardiology Associates of North Mississippi, Tupelo, Mississippi
James P. Zidar, MD: North Carolina Heart and Vascular, University of North Carolina, Raleigh, North Carolina
Pieter C. Smits, MD: Maasstad Ziekenhuis, Rotterdam, the Netherlands
Victor Alfonso Jiménez Díaz, MD: Hospital Álvaro Cunqueiro, Vigo, Spain
Brent McLaurin, MD: AnMed Health Medical Center, Anderson, South Carolina
David A. Brogno, MD: NewYork-Presbyterian Hospital/Columbia University Medical Center, New York, New York
Luc Janssens, MD: Department of Cardiology, Imeldaziekenhuis, Bonheiden, Belgium
Mathias C. Vrolix, MD: Ziekenhuis Oost-Limburg, Genk, Belgium
Iván Gómez-Blázquez, MD: Hospital 12 de Octubre, Madrid, Spain
Zakir H. Sahul, MD: Michigan Heart Ann Arbor, Ypsilanti, Michigan
Ameer Kabour, MD: Mercy Health – St Vincent Medical Center, Toledo, Ohio
Luisa Salido, MD: University Hospital Ramon y Cajal de Madrid, Madrid, Spain
Michael Cleman, MD: Division of Cardiology, Yale School of Medicine, New Haven, Connecticut
Shigeru Saito, MD: Shonan Kamakura General Hospital, Kamakura, Japan
Martin B. Leon, MD: Cardivascular Research Foundation, New York, New York; NewYork-Presbyterian Hospital/Columbia University Medical Center, New York, New York
Andreas Baumbach, MD: Barts Heart Centre, London, UK; Division of Cardiology, Yale School of Medicine, New Haven, Connecticut; Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University of London, London, UK; Corresponding author.

Journal volume & issue: Vol. 1, no. 1
p. 100004

Abstract

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Background: The Supreme healing-targeted drug-eluting stent (DES) is designed to promote endothelial healing to reduce stent-related adverse events. This may be particularly relevant among complex lesions that have a higher rate of adverse events. We sought to compare 1-year outcomes of percutaneous coronary intervention in complex lesions between the Supreme DES and contemporary durable-polymer, everolimus-eluting stents (DP-EES). Methods: PIONEER III was a multicenter, prospective, single-blind clinical trial, randomizing 1629 patients with either an acute or chronic coronary syndrome in a 2:1 ratio to the Supreme DES or DP-EES. Complex lesions (American College of Cardiology/American Heart Association type B2/C) were found in 1137 patients. Outcomes were also compared for specific parameters of lesion complexity: severe calcification, long length (>20 mm), and severe tortuosity. The primary end point was target lesion failure at 1 year. Results: At 1 year, there was no difference in target lesion failure between the Supreme DES and DP-EES: (5.7% vs 5.6%; hazard ratio 1.00, 95% confidence interval 0.59-1.68, P = .99). Similarly, there were no differences in the secondary end points of lesion success (99.7% vs 99.4%, P = .41), device success (97.0% vs 98.5%, P = .14), target vessel failure (6.5% vs 7.4%, P = .50), major adverse cardiac events (7.8% vs 8.5%, P = .64), or stent thrombosis (0.7% vs 1.1%, P = .48). A trend was observed toward a higher rate of target lesion revascularization with the Supreme DES (2.5% vs 0.9%, P = .06). Conclusions: This study suggests that the Supreme DES is as effective and safe at 1 year compared with the standard DP-EES across a broad spectrum of lesion complexity.

Published in Journal of the Society for Cardiovascular Angiography & Interventions

ISSN: 2772-9303 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the circulatory (Cardiovascular) system
Website: https://www.journals.elsevier.com/journal-of-the-society-for-cardiovascular-angiography-and-interventions

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