title: Impact of drug eluting stent length on outcomes of percutaneous coronary intervention (from the EVENT registry).
abstract: 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.
authors.affiliation: St. Joseph's Hospital, Syracuse, NY, USA.
authors.forename: Ronald P
authors.initials: RP
authors.lastname: Caputo
authors.forename: Ankush
authors.initials: A
authors.lastname: Goel
authors.forename: Michael
authors.initials: M
authors.lastname: Pencina
authors.forename: David J
authors.initials: DJ
authors.lastname: Cohen
authors.forename: Neal S
authors.initials: NS
authors.lastname: Kleiman
authors.forename: Chen-Hsing
authors.initials: CH
authors.lastname: Yen
authors.forename: Ron
authors.initials: R
authors.lastname: Waksman
authors.forename: Paul
authors.initials: P
authors.lastname: Tolerico
authors.forename: Gaurav
authors.initials: G
authors.lastname: Dhar
authors.forename: Paul
authors.initials: P
authors.lastname: Gordon
authors.forename: Richard G
authors.initials: RG
authors.lastname: Bach
authors.forename: John J
authors.initials: JJ
authors.lastname: Lopez
mesh_terms: D015906:Angioplasty, Balloon, Coronary; D003324:Coronary Artery Disease / Q000628:therapy*; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011474:Prosthesis Design; D012042:Registries; D016896:Treatment Outcome