Literature DB >> 20398864

The relationship and threshold of stent length with regard to risk of stent thrombosis after drug-eluting stent implantation.

Jon Suh1, Duk-Woo Park, Jong-Young Lee, In Hyun Jung, Seung-Whan Lee, Young-Hak Kim, Cheol Whan Lee, Sang-Sig Cheong, Jae-Joong Kim, Seong-Wook Park, Seung-Jung Park.   

Abstract

OBJECTIVES: The aim of this study was to evaluate the association between the length of the stented segment and the risk of stent thrombosis (ST) after drug-eluting stent (DES) implantation and to determine the cutoff value of stent length in higher risk of ST in routine clinical practice.
BACKGROUND: Despite the recommendations of full lesion coverage to prevent angiographic restenosis, the length of the stented segment has been a risk factor for DES-related ST.
METHODS: A total of 3,145 consecutive patients (4,667 lesions) who underwent DES implantation were analyzed. The independent association of stent length with ST and its predictive value were evaluated for a median 29.6 months (interquartile range 21.6 to 37.5 months).
RESULTS: Stent thrombosis occurred in 68 patients (2.2%) at 3 years. The stent length/lesion was an independent predictor of ST (hazard ratio: 1.11, 95% confidence interval: 1.06 to 1.15, p < 0.001). The threshold of stent length for predicting ST was 31.5 mm (area under the receiver-operating characteristic curve: 0.746, 95% confidence interval: 0.699 to 0.793, p < 0.001), which had a sensitivity and specificity of 88.4% and 52.1%, respectively. Stent lengths >or=31.5 mm were associated with higher rates of ST (4.0% vs. 0.7%, p < 0.001), death (5.2% vs. 3.0%, p = 0.005), and myocardial infarction (2.4% vs. 0.7%, p = 0.001) at 3 years, as compared with stent lengths <31.5 mm.
CONCLUSIONS: Length of the stented segment was independently associated with the incidence of ST and death or myocardial infarction after DES implantation. The value of stent length >or=31.5 mm is a threshold for the prediction of ST. Copyright (c) 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

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Year:  2010        PMID: 20398864     DOI: 10.1016/j.jcin.2009.10.033

Source DB:  PubMed          Journal:  JACC Cardiovasc Interv        ISSN: 1936-8798            Impact factor:   11.195


  27 in total

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