PROMUS Element Plus US Post-Approval Study

Cardiac death or myocardial infarction rate at 12 months post implantation in PLATINUM-like patients (no acute myocardial infarction, graft stenting, chronic total occlusion, in-stent restenosis, failed brachytherapy, bifurcation, ostial lesion, severe tortuosity, moderate/severe calcification, 3-vessel stenting, cardiogenic shock, left main disease, or acute/chronic renal dysfunction; lesion length ≤28 mm with reference vessel diameter ≥2.25 mm and \<2.5 mm, or lesion length ≤24 mm with diameter ≥2.5 mm and ≤4.25 mm); statistical testing will assess if rate meets the performance goal (3.2%)

Time frame: 12 months

Population: Note: PLATINUM-like population for the Primary Endpoint at 12 months includes PROMUS Element patients from the PLATINUM trials (WH and SV) (N=862), PLATINUM-like patients from PE-Prove (N=269), and PLATINUM-like patients from PROMUS Element Plus US Post-Approval Study (N=776) (as stated as a subgroup in the Participant Flow Module.

See description of individual events.

Time frame: ≤24 hours, 30 days, 180 days, annually through 5 years

All death includes cardiac death and non-cardiac death.

Time frame: ≤24 hours, 30 days, 180 days, annually through 5 years

Using the Academic Research Consortium (ARC) definition, the (definite/probable) stent thrombosis (ST) rate in the PLATINUM-like\* population will be analyzed. Statistical testing will be used to determine if the annual increase after the first year in ST rates observed in PLATINUM-like patients meets the performance goal of 1.0% (expected rate of 0.4% + a delta of 0.6%).

Time frame: Annually through 5 years

Population: Note: PLATINUM-like population for the Primary Endpoint at 12 months includes PROMUS Element patients from the PLATINUM trials (WH and SV) (N=862), PLATINUM-like patients from PE-Prove (N=269), and PLATINUM-like patients from PROMUS Element Plus US Post-Approval Study (N=776) (as stated as a subgroup in the Participant Flow Module.

See individual descriptions of events.

Time frame: ≤24 hours, 30 days, 180 days, annually through 5 years

Cardiac death is defined as death due to any of the following: acute myocardial infarction; cardiac perforation/pericardial tamponade; arrhythmia or conduction abnormality; cerebrovascular accident through hospital discharge or cerebrovascular accident suspected of being related to the procedure; death due to complication of the procedure, including bleeding, vascular repair, transfusion reaction, or bypass surgery; any death in which a cardiac cause cannot be excluded

Time frame: ≤24 hours, 30 days, 180 days, annually through 5 years

DEFINITE ST: acute coronary syndrome and angiographic or pathologic evidence of stent thrombosis; PROBABLE ST: unexplained death within 30 days or target-vessel infarction without angiographic information ARC ST is reported as a cumulative value at different time points and within the different separate time points. Time 0 is the time point after the guide catheter has been removed. Acute ST: 0-24 hours after stent implantation; Subacute ST: \>24 hours to 30 days post; late ST: \>30 days to 1 year post; Very late ST: \>1 year post; NOTE: Acute/subacute can be replaced by early ST (0-30 days)

Time frame: ≤24 hours, 30 days, 180 days, annually through 5 years

ARC definite/probable ST rate in PLATINUM-like patients (no acute myocardial infarction, graft stenting, chronic total occlusion, in-stent restenosis, failed brachytherapy, bifurcation, ostial lesion, severe tortuosity, moderate/severe calcification, 3-vessel stenting, cardiogenic shock, left main disease, or acute/chronic renal dysfunction; lesion length ≤28 mm with reference vessel diameter ≥2.25 mm and \<2.5 mm, or lesion length ≤24 mm with diameter ≥2.5 mm and ≤4.25 mm); statistical testing will assess if the annual ST rate increase after the first year meets the performance goal (1.0%)

Time frame: 12 months

Population: PROMUS Element PLATINUM-Like patients (a subgroup of the overall population as described in the Participant Flow Module), N=776.

Composite of cardiac death, myocardial infarction, and target vessel revascularization

Time frame: ≤24 hours, 30 days, 180 days, annually through 5 years

New Q-waves in ≥2 leads lasting ≥0.04 sec with creatine kinase myoglobin band(CK-MB) or troponin \>upper limit of normal(ULN); if no new Q-waves total CK levels \>3×ULN (peri-percutaneous coronary intervention \[PCI\]) or \>2×ULN (spontaneous) with elevated CK-MB or troponin \>3×ULN (peri-PCI) or \>2×ULN (spontaneous) plus ≥one of the following: ECG changes indicating new ischemia (new ST-T changes, left bundle branch block), imaging evidence of new loss of viable myocardium, new regional wall motion abnormality. Similar for MI diagnosis post coronary artery bypass graft with CK-MB or troponin \>5×ULN

Time frame: ≤24 hours, 30 days, 180 days, annually through 5 years

Non-cardiac death is defined as death not due to cardiac causes. Cardiac death is death due to any of the following: acute myocardial infarction; cardiac perforation/pericardial tamponade; arrhythmia or conduction abnormality; cerebrovascular accident through hospital discharge or cerebrovascular accident suspected of being related to the procedure; death due to complication of the procedure, including bleeding, vascular repair, transfusion reaction, or bypass surgery; any death in which a cardiac cause cannot be excluded.

Time frame: ≤24 hours, 30 days, 180 days, annually through 5 years

Cardiac death is defined as death due to any of the following: acute myocardial infarction; cardiac perforation/pericardial tamponade; arrhythmia or conduction abnormality; cerebrovascular accident through hospital discharge or cerebrovascular accident suspected of being related to the procedure; death due to complication of the procedure, including bleeding, vascular repair, transfusion reaction, or bypass surgery; any death in which a cardiac cause cannot be excluded

Time frame: ≤24 hours, 30 days, 180 days, annually through 5 years

See individual descriptions of events.

Time frame: ≤24 hours, 30 days, 180 days, annually through 5 years

Compression/elongation of a stent along its long axis resulting from interaction with an ancillary device (e.g., guide catheter) which catches the stent end or an internal stent strut; can occur with advancement or withdrawal of ancillary device. Under fluoroscopy, longitudinal compression usually results in increased strut density and elongation in decreased strut density ('pseudo-fracture'); both can occur in the same stent.

Time frame: Index Procedure

Composite of cardiac death, myocardial infarction, and target vessel revascularization related to the PROMUS Element stent

Time frame: ≤24 hours, 30 days, 180 days, annually through 5 years

New Q-waves in ≥2 leads lasting ≥0.04 sec with creatine kinase myoglobin band(CK-MB) or troponin \>upper limit of normal(ULN); if no new Q-waves total CK levels \>3×ULN (peri-percutaneous coronary intervention \[PCI\]) or \>2×ULN (spontaneous) with elevated CK-MB or troponin \>3×ULN (peri-PCI) or \>2×ULN (spontaneous) plus ≥one of the following: ECG changes indicating new ischemia (new ST-T changes, left bundle branch block), imaging evidence of new loss of viable myocardium, new regional wall motion abnormality. Similar for MI diagnosis post coronary artery bypass graft with CK-MB or troponin \>5×ULN

Time frame: ≤24 hours, 30 days, 180 days, annually through 5 years

Target vessel failure (TVF) is defined as any revascularization of the target vessel, myocardial infarction (MI) related to the target vessel, or death related to the target vessel. For the purposes of this protocol, if it cannot be determined with certainty whether MI or death was related to the target vessel it will be considered TVF.

Time frame: ≤24 hours, 30 days, 180 days, annually through 5 years

Target vessel revascularization is defined as any attempted or successfully completed percutaneous or surgical revascularization of a target vessel.

Time frame: ≤24 hours, 30 days, 180 days, annually through 5 years

Target vessel failure (TVF) is defined as any revascularization of the target vessel, myocardial infarction (MI) related to the target vessel, or death related to the target vessel. For the purposes of this protocol, if it cannot be determined with certainty whether MI or death was related to the target vessel it will be considered TVF.

Time frame: ≤24 hours, 30 days, 180 days, annually through 5 years

Any revascularization of the target vessel, myocardial infarction related to the target vessel, or death related to the target vessel. See individual components for descriptions. Statistical testing will determine if the rate meets the performance goal (12.6%)

Time frame: 12 Months

Target vessel revascularization is defined as any attempted or successfully completed percutaneous or surgical revascularization of a target vessel.

Time frame: ≤24 hours, 30 days, 180 days, annually through 5 years