Impact of Drug Eluting Stent Length on Outcomes of Percutaneous Coronary Intervention (from the EVENT Registry)

Caputo, Ronald P.; Goel, Ankush; Pencina, Michael J.; Cohen, David J.; Kleiman, Neal S.; Yen, Chen Hsing; Waksman, Ron; Tolerico, Paul H.; Dhar, Gaurav; Gordon, Paul; Bach, Richard G.; López, John J.

doi:10.1016/j.amjcard.2012.03.031

Cited by 33 publications

(18 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Several studies have suggested that longer lesions were associated with higher MACE rates in the BMS and DES eras [12], [26], [27]. Our results showed similar results in the BMS group, but not in the DES group.…”

Section: Discussionsupporting

confidence: 82%

See 1 more Smart Citation

Lesion Length Impacts Long Term Outcomes of Drug-Eluting Stents and Bare Metal Stents Differently

et al. 2013

View full text Add to dashboard Cite

BackgroundLong lesions have been associated with adverse outcomes in percutaneous coronary interventions with bare metal stents (BMS). However, the exact impact of lesion length on the short- and long-term outcomes of drug-eluting stent (DES) implantations is not as clear.Methods and ResultsThis study compared the impact of lesion length on angiographic and clinical outcomes of BMS and DES in a single-center prospective registry. Lesion length was divided into tertiles. The primary endpoints were angiographically defined binary in-stent restenosis (ISR) rate and major adverse cardiac event (MACE). Of the 4,312 de novo lesions in 3,447 consecutive patients in the CAPTAIN registry, 2,791 lesions (of 2,246 patients) received BMS, and the remaining 1,521 lesions (of 1,201 patients) received DES. The mean follow-up duration was 4.5 years. The longer the lesion, the higher the ISR rate (14%, 18%, and 29%, p<0.001) and the lower the MACE-free survivals (p = 0.007) in the BMS group. However, lesion length showed no such correlation with ISR rates (4.7%, 3.3%, and 7.8%, p = 0.67) or MACE-free survivals (p = 0.19) in the DES group.ConclusionsIn our single-center prospective registry, lesion length defined in tertiles has no impact on the short-term (ISR) or long-term (MACE) outcomes of patients implanted with DES. In contrast, longer lesion correlates with higher ISR and MACE rates in BMS group.

show abstract

Section: Discussionsupporting

confidence: 82%

“…On the other hand, the effect of lesion length on the long term outcomes in the DES era has been ignored. A very recent study suggested that longer stents are associated with increased MACE rates at 1 year [12]. The exact difference in impact of lesion length on the long term outcomes for BMS and DES, however, is not clear.…”

Section: Introductionmentioning

confidence: 99%

Lesion Length Impacts Long Term Outcomes of Drug-Eluting Stents and Bare Metal Stents Differently

et al. 2013

View full text Add to dashboard Cite

show abstract

“…Caputo et al reported that a longer DES length was associated with increased adverse events (major adverse cardiac events including MI and target lesion revascularization). Although DES length was not an independent predictor of adverse events in that study, there was a tendency for an increased risk (p = 0.1) [22]. Stent length could well be associated with any CV event, including ST.…”

Section: Discussionmentioning

confidence: 94%

Relation between stent thrombosis and calcium channel blocker after drug-eluting stent implantation

Nagano

Hokimoto

Nakao

et al. 2015

Journal of Cardiology

View full text Add to dashboard Cite

show abstract

“…The main problems of longer length of DES are associated with an increased risk of "hard" clinical outcomes (i.e., stent thrombosis) as well as "soft" clinical outcomes (i.e., restenosis) 5,6,7. In addition, previous studies revealed that DES overlap was an independent predictor of overall stent thrombosis and was associated with impaired angiographic and long-term clinical outcome 19,20.…”

Section: Discussionmentioning

confidence: 99%

“…The use of longer or multiple stents could be an inevitable consequence of spanning the full lesion between angiographically "healthy to healthy" segment 4. However, longer stent length has been indicated as an independent prognostic factor predicting adverse clinical outcomes with an increased rate of stent thrombosis and restenosis, even in the era of the drug-eluting stent (DES) 5,6,7. To treat physically long coronary lesions in the era of the bare-metal stent, intravascular ultrasound-guided balloon angioplasty with provisional spot stenting was suggested, and the angiographic and clinical outcomes of this strategy were favorable compared to the matched control group treated with full lesion coverage 8.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Full Lesion Coverage versus Spot Drug-Eluting Stent Implantation for Coronary Artery Stenoses

et al. 2014

View full text Add to dashboard Cite

PurposeThe aim of this study was to evaluate and compare the long-term clinical outcomes of the spot drug-eluting stent (DES) implantation strategy, which is used to minimize implanted stent length and the number of stents, versus full lesion coverage for treatment of coronary artery stenoses.Materials and MethodsWe evaluated 1-year clinical outcomes of 1619 patients with stent implantation for a single coronary lesion. They were divided into two groups: those treated by full lesion coverage (n=1200) and those treated with the spot stenting strategy (n=419). The combined occurrence of 1-year target vessel failure (TVF), including cardiac death, target-vessel related myocardial infarction, or ischemia-driven target-vessel revascularization was evaluated.ResultsThe spot DES implantation group had a shorter stent length (23.14±9.70 mm vs. 25.44±13.24 mm, respectively; p<0.001) and a fewer number of stents (1.09±0.30 vs. 1.16±0.41, respectively; p<0.001), even though the average lesion length was similar to the full lesion coverage group (21.36±10.30 mm vs. 20.58±10.97 mm, respectively; p=0.206). Spot DES implantation was superior to full DES coverage with respect to 1-year TVF (1.4% vs. 3.3%, p=0.044). Cox proportional hazard model analysis showed that the risk for 1-year TVF was almost 60% lower among patients who received spot DESs compared to those who received full DES coverage after adjustment for other risk factors (HR=0.40, 95% confidence interval=0.17-0.98; p=0.046).ConclusionMinimizing stent length and the number of stents with overlapping by spot DES implantation may result in reduced rates of 1-year TVF, compared with full DES coverage.

show abstract

Impact of Drug Eluting Stent Length on Outcomes of Percutaneous Coronary Intervention (from the EVENT Registry)

Cited by 33 publications

References 23 publications

Lesion Length Impacts Long Term Outcomes of Drug-Eluting Stents and Bare Metal Stents Differently

Lesion Length Impacts Long Term Outcomes of Drug-Eluting Stents and Bare Metal Stents Differently

Relation between stent thrombosis and calcium channel blocker after drug-eluting stent implantation

Comparison of Full Lesion Coverage versus Spot Drug-Eluting Stent Implantation for Coronary Artery Stenoses

Contact Info

Product

Resources

About