title: Impact of the stent length on long-term clinical outcomes following newer-generation drug-eluting stent implantation.
abstract: Stent length has been considered an important predictor of adverse events after percutaneous coronary intervention, even with the first-generation drug-eluting stents (DESs). The introduction of newer-generation DES has further reduced the rates of adverse clinical events such as restenosis, myocardial infarction, and stent thrombosis. The aim of this study was to compare the impact of stent length on the long-term clinical outcomes between first- and newer-generation DESs. The effects of stent length (≥32 vs <32 mm) on the clinical outcomes were evaluated in 8,445 patients who underwent percutaneous coronary intervention using either a first-generation DES (sirolimus- and paclitaxel-eluting stents, n = 6,334) or a newer-generation DES (everolimus- and zotarolimus-eluting stents, n = 2,111) from January 2004 to December 2009. The 3-year adverse outcomes (composite of all-cause death, nonfatal myocardial infarction, target vessel revascularization, and stent thrombosis) were compared using the inverse probability of treatment-weighted method according to the stent length. After adjustment for differences in the baseline risk factors, a stent length of ≥32 mm was significantly associated with higher cumulative rates of target vessel revascularization and stent thrombosis in the patients treated with a first-generation DES (adjusted hazard ratio 1.875, 95% confidence interval 1.531 to 2.297, p <0.001; adjusted hazard ratio 2.964, 95% confidence interval 1.270 to 6.917, p = 0.012), but it was not associated with the clinical outcomes in patients treated with a newer-generation DES. In conclusion, stent length might not be associated with long-term clinical outcomes in newer-generation DES era, whereas stent length might be associated with long-term clinical outcomes in the first-generation DESs.
authors: Cardiovascular Center, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
authors: Ik Jun
authors: IJ
authors: Choi
authors: Cardiovascular Center, Uijeongbu St Mary's Hospital, The Catholic University of Korea, Uijeongbu, Korea. Electronic address: kyoonseok@catholic.ac.kr.
authors: Yoon-Seok
authors: YS
authors: Koh
authors: Cardiovascular Center, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
authors: Sungmin
authors: S
authors: Lim
authors: Cardiovascular Center, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
authors: Jin Jin
authors: JJ
authors: Kim
authors: Cardiovascular Center, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
authors: Mineok
authors: M
authors: Chang
authors: Cardiovascular Center, Uijeongbu St Mary's Hospital, The Catholic University of Korea, Uijeongbu, Korea.
authors: Minkyu
authors: M
authors: Kang
authors: Cardiovascular Center, St. Paul's Hospital, The Catholic University of Korea, Seoul, Korea.
authors: Byung-Hee
authors: BH
authors: Hwang
authors: Cardiovascular Center, Daejeon St. Mary's Hospital, The Catholic University of Korea, Daejeon, Korea.
authors: Chan Jun
authors: CJ
authors: Kim
authors: Cardiovascular Center, Uijeongbu St Mary's Hospital, The Catholic University of Korea, Uijeongbu, Korea.
authors: Tae-Hoon
authors: TH
authors: Kim
authors: Cardiovascular Center, Incheon St. Mary's Hospital, The Catholic University of Korea, Incheon, Korea.
authors: Suk Min
authors: SM
authors: Seo
authors: Cardiovascular Center, Incheon St. Mary's Hospital, The Catholic University of Korea, Incheon, Korea.
authors: Dong Il
authors: DI
authors: Shin
authors: Cardiovascular Center, Daejeon St. Mary's Hospital, The Catholic University of Korea, Daejeon, Korea.
authors: Mahn Won
authors: MW
authors: Park
authors: Cardiovascular Center, Yeouido St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
authors: Yun-Seok
authors: YS
authors: Choi
authors: Cardiovascular Center, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
authors: Hun-Jun
authors: HJ
authors: Park
authors: Cardiovascular Center, Daejeon St. Mary's Hospital, The Catholic University of Korea, Daejeon, Korea.
authors: Sung-Ho
authors: SH
authors: Her
authors: Cardiovascular Center, St. Paul's Hospital, The Catholic University of Korea, Seoul, Korea.
authors: Dong-Bin
authors: DB
authors: Kim
authors: Cardiovascular Center, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
authors: Pum-Joon
authors: PJ
authors: Kim
authors: Cardiovascular Center, Uijeongbu St Mary's Hospital, The Catholic University of Korea, Uijeongbu, Korea.
authors: Jong Min
authors: JM
authors: Lee
authors: Cardiovascular Center, Yeouido St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
authors: Chul Soo
authors: CS
authors: Park
authors: Cardiovascular Center, St. Vincent's Hospital, The Catholic University of Korea, Suwon, Korea.
authors: Keon Woong
authors: KW
authors: Moon
authors: Cardiovascular Center, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
authors: Kiyuk
authors: K
authors: Chang
authors: Cardiovascular Center, Bucheon St. Mary's Hospital, The Catholic University of Korea, Bucheon, Korea.
authors: Hee Yeol
authors: HY
authors: Kim
authors: Cardiovascular Center, St. Vincent's Hospital, The Catholic University of Korea, Suwon, Korea.
authors: Ki Dong
authors: KD
authors: Yoo
authors: Cardiovascular Center, Incheon St. Mary's Hospital, The Catholic University of Korea, Incheon, Korea.
authors: Doo Soo
authors: DS
authors: Jeon
authors: Cardiovascular Center, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
authors: Wook-Sung
authors: WS
authors: Chung
authors: Cardiovascular Center, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
authors: Ki-Bae
authors: KB
authors: Seung
mesh_terms: D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000601:surgery*; D023903:Coronary Restenosis / Q000453:epidemiology / Q000517:prevention & control*; D054855:Drug-Eluting Stents; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology / Q000517:prevention & control*; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D011446:Prospective Studies; D011474:Prosthesis Design; D056910:Republic of Korea / Q000453:epidemiology; D018570:Risk Assessment / Q000379:methods*; D015996:Survival Rate / Q000639:trends; D013997:Time Factors