Influence of Stent Length on Periprocedural Outcomes After Primary Percutaneous Coronary Intervention in Patients with ST Segment Elevation Myocardial Infarction

Abstract

A longer stent is associated with adverse events after percutaneous coronary intervention (PCI). However, little information is available on the relationship between stent length and periprocedural prognosis in patients with ST segment elevation myocardial infarction (STEMI). We aimed to assess the target vessel stent length influence on angiographic outcomes and in-hospital major adverse cardiovascular event (MACE) during primary PCI in patients with STEMI. Patients and Methods: This single-center retrospective observational study included 246 patients with STEMI admitted to the Zhejiang Provincial People's Hospital between January 2019 and December 2021, who underwent primary PCI and successful stent implantation. The exclusion criteria included left main lesion, multiple diseased vessel-stenting, bleeding disorders, contrast allergy, and incomplete data. Patients were divided into two groups based on the median stents length: group A (≤29 mm, n=125) and group B (>29mm, n=121). Periprocedural outcomes were slow flow/no-reflow (SF-NR) and in-hospital MACE, which included acute heart failure, malignant arrhythmia, cardiovascular death, non-fatal stroke, non-fatal myocardial infarction, and urgent revascularization. Multivariate logistic analyses were used to explore the correlation between stent length and SF-NR. Results: A total of 246 patients (82.9% males) with a mean age of 59.9±12.6 years were included in the analysis. The incidence of SF-NR was significantly higher in group B than in group A (36.4% vs 23.2%, p=0.024). However, the in-hospital MACE incidence rate was similar between the two groups (7.2% vs 7.4%, p=0.943). Multivariate logistic regression analysis showed that stent length and diameter, and peak troponin I level were independent risk factors for SF-NR. Conclusion: Excessive stent length is an independent risk factor for SF-NR, without any significant influence on the risk of MACE during hospitalization.

The relationship between homocysteine and no-reflow phenomenon in patients undergoing primary percutaneous coronary intervention

“…28 Among these, age and hypertension were also associated with no-reflow in the present study. Along the lines of previous reports, distal embolization, 29 ischemia time, 30 stent length, 31 and postdilatation 31 were also associated with no-reflow in the current work.…”

Value of Hcy combined with Framingham score for predicting macrovascular disease in elderly patients with type 2 diabetes

“…[ 22 , 23 ] Patients with long-lasting diabetes are also at high risk of developing cardiovascular disease owing to their chronic insulin resistance and hypercoagulable blood. [ 24 ] The Framingham score is a Class I recommendation in the American Heart Association guidelines for the assessment of cardiovascular risk in asymptomatic adults. The Framingham score has been used in China to predict cardiovascular disease in the population and has been shown to have better predictive validity and discriminatory power owing to the high number of factors included in the score.…”

Risk Factors of Suboptimal Coronary Blood Flow after a Percutaneous Coronary Intervention in Patients with Acute Anterior Wall Myocardial Infarction

“…The longer total length of the stents may be conducive to more extensive endothelium damage and promotes microvascular constriction. Furthermore, implantation of stents and balloon dilation may lead to thrombus dislodgement, which results in mechanical obstruction [24]. Glycoprotein IIb/IIIa (GP IIb/IIIa) inhibitors decrease platelet aggregation by preventing fibrinogen from binding to the glycoprotein IIb/IIIa receptors located on the platelet surface [25].…”