PLATINUM DIVERSITY: PCI Outcomes in Women and Minorities
Although there were no significant differences in stent-related outcomes, both women and minorities had higher rates of death and myocardial infarction (MI) in the first year following percutaneous coronary intervention (PCI), according to the results of the PLATINUM DIVERSITY Trial presented Nov. 1 at TCT 2016.
Wayne B. Batchelor, MD, FACC, et al., conducted a multicenter, single-arm, prospective cohort study of 1,501 women and minorities at 52 sites in the U.S. Patient information was pooled with data from the PROMUS ELEMENT PAS Study (PE Plus PAS, n=2,687) and each group was compared with white men enrolled in the PE Plus PAS (n=1,635).
The results of the study showed that, in terms of individual endpoints, minorities had the highest rate of death and MI, whereas white men had the highest rate of target vessel revascularization at one year. Death was 3.7 percent in minorities and 3.4 percent in women, compared with white men (2.2 percent); MI was 3.1 percent in minorities and 1.9 percent in women versus 1.1 percent in white men; target vessel regurgitation was 5.4 percent in minorities and 4.6 percent in women compared with white men (5.5 percent).The combined primary endpoint of death, Ml and target vessel revascularization at one year was 7.6 percent for white men compared with 9.6 percent for minorities and 8.6 percent for women.
Batchelor notes that “the similar rates of target vessel regurgitation and stent thrombosis among all three groups suggest that ‘stent failure’ is unlikely to account for the observed differences in outcome. Further study into the cause of these observed gradients of risk is necessary to gain insight into the potential impact on clinical practice.”
Roxana Mehran, MD, FACC, co-investigator of the study and chair of ACC’s Interventional Section, adds that this trial “represents an important example of how we can enrich our understanding of outcomes in the underrepresented population. This is the first trial exclusively enrolling women and minorities undergoing PCI and allows for further evaluation of patients who are usually not represented in clinical studies.”
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