Rationale and design of the East-West late lumen loss study: Comparison of late lumen loss between Eastern and Western drug-eluting stent study cohorts

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• 作者：Robert W. Harrison ; MD^a ; ^{robert.w.harrison@duke.edu} ; Vaishnavi Radhakrishnan ; MD^b ; Peter S. Lam ; PhD^c ; Dominic J. Allocco ; MD^c ; Sandeep Brar ; MD^d ; Martin Fahy ; MSc^d ; Rebecca Fisher^a ; Fumiaki Ikeno ; MD^e ; Philippe Gé ; né ; reux ; MD^f ; Takeshi Kimura ; MD ; PhD^g ; Minglei Liu ; PhD^d ; Weng Kit Lye ; MS^b ; Gary S. Mintz ; MD^f ; Hirofumi Nagai ; PhD^h ; Yuka Suzuki ; MDⁱ ; Roseann White ; MA^j ; John C. Allen Jr ; PhD^b ; Mitchell W. Krucoff ; MD^a
• 刊名：American Heart Journal
• 出版年：2016
• 出版时间：December 2016
• 年：2016
• 卷：182
• 期：Complete
• 页码：103-110
• 全文大小：175 K
• 卷排序：182

文摘

The contemporary evaluation of novel drug-eluting stents (DES) includes mechanistic observations that characterize postdeployment stent behavior. Quantification of late lumen loss due to neointimal hyperplasia 8-13 months after stent implantation, via quantitative coronary angiography (QCA), constitutes such an observation and is required by most regulatory authorities. Late lumen loss, as determined by QCA, has been validated as a surrogate for clinical endpoints such as target vessel revascularization. The mechanistic response to DES has not been directly compared across predominantly Asian or Western populations, whereas understanding their comparability across geographic populations could enhance global DES evaluation.ObjectiveThe East-West late lumen loss study is designed to demonstrate whether the residual differences in late lumen loss, as assessed by QCA, is different between Eastern and Western DES recipients from studies with protocol angiography at 8-13 months of follow-up.MethodsData from independent core laboratories that have characterized angiographic late lumen loss in DES clinical trials with protocol follow-up angiography will be compiled and dichotomized into Eastern and Western populations. A prospectively developed propensity score model incorporating clinical and anatomic variables affecting late lumen loss will be used to adjust comparisons of QCA measurements.ConclusionDocumentation of whether there are clinically meaningful differences in mechanistic response to DES implantation across genetically unique geographies could facilitate both the quality and efficiency of global device evaluation requiring invasive follow-up for novel stent designs.