Key result
Longer total stent length linked to ~3% higher periprocedural ischemic risk per millimeter.
Why the study?
Do specific stent characteristics (such as length and eluted drug) increase the risk of periprocedural ischemic events in patients with chronic coronary syndrome undergoing elective PCI?
Cohort
Do specific stent characteristics (such as length and eluted drug) increase the risk of periprocedural ischemic events in patients with chronic coronary syndrome undergoing elective PCI?
Answers are grounded in this paper and cite their sources.
In elective PCI for chronic coronary syndrome, longer total stent length and the use of biolimus-eluting stents are associated with an increased risk of periprocedural ischemic events.
BACKGROUND: Stents characteristics can have a tremendous impact on the incidence of periprocedural ischemic events following percutaneous coronary intervention (PCI) in patients with chronic coronary syndrome (CCS). The ALPHEUS-stents study aimed to describe the association between stents lengths and characteristics on the occurrence of periprocedural ischemic events. METHODS: The study included patients with CCS undergoing elective PCI with at least one high-risk feature. The primary endpoint of the study was the composite of type 4a/4b myocardial infarction (MI) and periprocedural major myocardial injury evaluated at 48 h or discharge. First, we evaluated the association between total stent length and primary outcome using a multivariate logistic regression considering stent length as a continuous variable and adjusting for relevant covariates. Then we evaluated the associations between stent diameter, strut thickness, platform composition, polymer type, coating distribution and eluted drugs with the primary endpoint using a multivariable logistic regression model, with stent length categorized within the aforementioned subgroups. RESULTS: The primary endpoint occurred in 639 patients (35.8%). After adjustment, total stent length was significantly associated with the primary endpoint (adjusted Odds Ratio (aOR) 1.028 95%CI [1.028-1.029] per millimeter). No significant associations were observed across categories of stent diameter, strut thickness, platform composition or coating distribution. However, biolimus-eluting stents (aOR 1.051 [1.035-1.067], p = 0.006 vs other eluted drugs) were independently associated with an increased risk of the primary outcome. CONCLUSIONS: In patients undergoing elective PCI, the risk of periprocedural ischemic events is adequately captured by the total stent length. Biolimus-eluted stents might confer a higher risk of periprocedural ischemic events. CLINICALTRIALS: gov number: NCT02617290.
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Giovachini et al. (2026) conducted a cohort in Chronic coronary syndrome (CCS). Total stent length and stent characteristics vs. Shorter stent length and other eluted drugs was evaluated on Composite of type 4a/4b myocardial infarction (MI) and periprocedural major myocardial injury evaluated at 48 h or discharge (aOR 1.028, 95% CI 1.028-1.029). Total stent length (aOR 1.028 per mm; 95% CI 1.028-1.029) and biolimus-eluting stents (aOR 1.051; 95% CI 1.035-1.067; p=0.006) were associated with increased risk of periprocedural ischemic events.
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