Impact of total stent length after cobalt chromium everolimus-eluting stent implantation on 3-year clinical outcomes

Objectives

The objective was to assess whether total stent length (TSL) after cobalt-chromium everolimus-eluting stent (CoCr-EES) implantation was associated with long-term clinical outcomes.

Background

The impact of TSL after CoCr-EES implantation on long-term clinical outcomes remained unclear.

Methods

A total of 1,007 consecutive patients with 1,382 lesions treated only with CoCr-EES were analyzed. Patients and lesions were divided into tertile group: TSL per patient (TSL-P) (PA [8–23 mm], n = 382; PB [23–46 mm], n = 312; and PC [46–204 mm], n = 313), and TSL per lesion (TSL-L) (LA [8–18 mm], n = 486; LB [18–28 mm], n = 475; and LC [28–140 mm], n = 421). The cumulative 3-year incidence of clinically driven target-lesion revascularization (CD-TLR) and definite stent thrombosis (ST) based on TSL-P and TSL-L groupings were accessed.

Results

After inverse probability of weighted adjustment, the cumulative 3-year incidence of CD-TLR for the TSL-P and TSL-L were higher in the PC and LC groups than in the other groups (hazard ratio [HR] 2.92, 95% confidence intervals [CI] 1.66–5.15, P < 0.001 vs. PA; HR 2.49, 95% CI 1.47–4.20, P < 0.001 vs. PB; HR 1.94, 95% CI 1.15–3.28, P = 0.01 vs. LA; HR 2.80, 95% CI 1.73–4.54, P < 0.001 vs. LB, respectively). No significant differences in the cumulative 3-year incidence of definite ST were observed in both TSL-P and TSL-L groups.

Conclusions

TSL after CoCr-EES implantation has significantly impact on CD-TLR rate through 3 years, but it is not associated with an increased incidence of definite ST. © 2016 Wiley Periodicals, Inc.

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