Impact of Drug Eluting Stents’ Length and Diameter on Short Term Outcome in Patients Undergoing Primary Percutaneous Coronary Intervention

Abstract

Introduction Little information is available on the impact of drug eluting stents (DES) on Major adverse cardiac events (MACEs). Aim was to assess the impact of stent length and diameter on angiographic and MACE outcomes during in-hospital & short term follow up in patients undergoing primary percutaneous coronary intervention (PPCI). Methods This is a single-center prospective observational study that included 404 patients who underwent primary PCI. Exclusion criteria were previous PCI, ectatic lesions, multi-vessel disease, and complex lesions. Stent length was divided into <20 mm, 20 - 40 mm and > 40 mm. Stent diameter was divided into < 3.0 mm, 3.0 – 3.5 mm and > 3.5 mm. Outcomes include angiographic data, e.g slow flow/no-reflow (SF-NR), and in-hospital and 3 months’ follow up MACE assessment. Results 404 patients (79% males, mean age 56 ± 11.35 years) were included. There was higher incidence of SF-NR (P=0.016), pre-dilatation (P= 0.01), median door to device time (P=0.011), median of onset of chest pain to wire time (P=<0.001), mean procedure time (P=<0.001) and mean contrast amount (P=0.013) for longer stents vs. medium and shorter stents. Patients having longer stents had significantly higher incidence of recurrent attacks of acute coronary syndrome (ACS) during the follow up period (P=0.003), and no significant difference was detected regarding other MACEs. Side branch compromise was more prevalent in larger diameter stents (P=0.042). In-hospital and 3 months’ follow up MACE incidence was similar. Conclusion Long DESs during PPCI are associated with higher incidence of SF-NR, however stent diameter has no impact on outcomes. Trial registration number in Clinical trials.gov.: NCT04110691