Effect of Increasing Stent Length on 3-Year Clinical Outcomes in Women Undergoing Percutaneous Coronary Intervention With New-Generation Drug-Eluting Stents: Patient-Level Pooled Analysis of Randomized Trials From the WIN-DES Initiative.
JACC Cardiovasc Interv
new-generation drug-eluting stents; patient-level pooled analysis of women; percutaneous coronary intervention; stent length per lesion; stent length per patient
OBJECTIVES: The aim of this study was to examine whether stent length per patient and stent length per lesion are negative markers for 3-year outcomes in women following percutaneous coronary intervention (PCI) with new-generation drug-eluting stents (DES).
BACKGROUND: In the era of advanced stent technologies, whether stent length remains a correlate of adverse outcomes is unclear.
METHODS: Women treated with new-generation DES in 14 randomized trials from the WIN-DES (Women in Innovation and Drug-Eluting Stents) pooled database were evaluated. Total stent length per patient, which was available in 5,403 women (quartile 1, 8 to 18 mm; quartile 2, 18 to 24 mm; quartile 3, 24 to 36 mm; quartile 4, ≥36 mm), and stent length per lesion, which was available in 5,232 women (quartile 1, 8 to 18 mm; quartile 2, 18 to 20 mm; quartile 3, 20 to 27 mm; quartile 4, ≥27 mm) were analyzed in quartiles. The primary endpoint was 3-year major adverse cardiovascular events (MACE), defined as a composite of all-cause death, myocardial infarction, or target lesion revascularization.
RESULTS: In the per-patient analysis, a stepwise increase was observed with increasing stent length in the adjusted risk for 3-year MACE (p for trend
CONCLUSIONS: In this pooled analysis of women undergoing PCI with new-generation DES, increasing stent length per patient and per lesion were independent predictors of 3-year MACE but were not associated with definite or probable stent thrombosis.
Chandrasekhar, Jaya; Baber, Usman; Sartori, Samantha; Stefanini, Giulio G; Sarin, Michele; Vogel, Birgit; Farhan, Serdar; Camenzind, Edoardo; Leon, Martin B; Stone, Gregg W; Serruys, Patrick W; Wijns, William; Steg, Philippe G; Weisz, Giora; Chieffo, Alaide; Kastrati, Adnan; Windecker, Stephan; Morice, Marie-Claude; Smits, Pieter C; von Birgelen, Clemens; Mikhail, Ghada W; Itchhaporia, Dipti; Mehta, Laxmi; Kim, Hyo-Soo; Valgimigli, Marco; Jeger, Raban V; Kimura, Takeshi; Galatius, Søren; Kandzari, David; Dangas, George; and Mehran, Roxana, "Effect of Increasing Stent Length on 3-Year Clinical Outcomes in Women Undergoing Percutaneous Coronary Intervention With New-Generation Drug-Eluting Stents: Patient-Level Pooled Analysis of Randomized Trials From the WIN-DES Initiative." (2018). Articles, Abstracts, and Reports. 105.