Population
Complex lesions were defined as American College of Cardiology/American Heart Association type B2 or C. The analysis included long lesions, severe calcification and severe tortuosity assessed by an independent angiographic core laboratory.
One-year outcome
Target-lesion failure was 5.7% with Supreme DES and 5.6% with the comparator (hazard ratio 1.00; 95% CI, 0.59-1.68; P=0.99).
Secondary outcomes
The investigators reported no significant differences in lesion success, device success, target-vessel failure, major adverse cardiac events or stent thrombosis. A numerical trend toward higher target-lesion revascularisation was reported with Supreme DES (2.5% versus 0.9%; P=0.06).
Interpretation
The publication concluded that the findings suggest comparable safety and effectiveness at one year across a broad spectrum of lesion complexity. As a subgroup analysis, the results should be interpreted alongside the full PIONEER III trial and the paper's stated limitations.