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

• Published in: The American journal of cardiology Vol. 110; no. 3; pp. 350 - 355
• Main Authors: Caputo, Ronald P., MD, Goel, Ankush, MD, Pencina, Michael, PhD, Cohen, David J., MD, MSc, Kleiman, Neal S., MD, Yen, Chen-Hsing, MS, Waksman, Ron, MD, Tolerico, Paul, MD, Dhar, Gaurav, MD, Gordon, Paul, MD, Bach, Richard G., MD, Lopez, John J., MD
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.08.2012; Elsevier; Elsevier Limited
• Subjects: Angioplasty, Balloon, Coronary; Biological and medical sciences; Cardiology; Cardiology. Vascular system; Cardiovascular; Clinical outcomes; Clinical trials; Coronary Artery Disease - therapy; Diseases of the cardiovascular system; Drug-Eluting Stents - adverse effects; Female; Heart attacks; Humans; Male; Medical sciences; Middle Aged; Prospective Studies; Prosthesis Design; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Registries; Stents; Treatment Outcome; Atherectomy; Prognosis; Angioplasty; Length; Coronary artery; Instrumentation therapy; Circulatory system; Cardiology; Drug eluting stent; Percutaneous route
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2012.03.031

In randomized trials, longer drug-eluting stent (DES) length has been associated with adverse clinical events. We used data from the EVENT registry to examine the impact of DES length on outcomes in routine clinical practice. We identified 5,425 unselected consecutive patients from the EVENT registry who had a single vessel treated with DES for nonemergency indications from 2004 through 2007. The association between stented length and short- and long-term outcomes was analyzed in ordinal categories (<15, 15 to 19, 20 to 24, and >24 mm) and as a continuous variable. There were few differences in baseline characteristics across categories. At 1 year, there was a stepwise increase in major adverse cardiac events (composite of death, myocardial infarction [MI], and target lesion revascularization [TLR]) with increasing stent length (8.0%, 10.1%, 11.8%, and 14.8%, p <0.001) and a similar relation with TLR (3.0%, 3.1%, 3.3%, and 5.0%, p = 0.02). After adjusting for demographic, clinical, angiographic, and treatment characteristics, longer stent length remained associated with 1-year major adverse cardiac events (adjusted hazard ratio 1.17 per 10-mm increase stent length) and TLR (hazard ratio 1.20 per 10 mm), but not with stent thrombosis. In conclusion, longer DES length is associated with increased adverse events, predominantly periprocedural MI, but also an increased rate of TLR.