Key result
Long stent length (≥32 mm) was not associated with increased major adverse cardiovascular events compared to short stents (<18 mm) in STEMI patients after primary PCI (7.6% vs 10.4%; P=0.633).
Why the study?
Does a longer stent length increase adverse clinical outcomes in STEMI patients receiving primary PCI?
Cohort (n=686)
Does a longer stent length increase adverse clinical outcomes in STEMI patients receiving primary PCI?
Absolute Event Rate: 7.6% vs 10.4%
p-value: p=0.633
Stent length was not associated with adverse clinical outcomes in STEMI patients undergoing primary PCI, suggesting that longer stents can be used safely when clinically indicated.
May support longer stents when needed in STEMI PCI; leaves open need for randomized confirmation.
BACKGROUND: A longer stent length is known to be a predictor of adverse events after a percutaneous coronary intervention (PCI). However, the evaluation of the stent length on the outcome of ST-segment elevation myocardial infarction (STEMI) patients is not enough. PATIENTS AND METHODS: A total of 686 STEMI patients who underwent primary PCI were divided into four groups according to the total stent length as follows: short (<18 mm, n=183), lower-medium (18-23 mm, n=256), upper-medium (24-31 mm, n=155), and long (≥32 mm, n=92). We compared the all-cause mortality, major adverse cardiovascular events (MACEs; composite of cardiovascular death, myocardial infarction, and stroke after discharge), target lesion revascularization, and target vessel revascularization with a median follow-up of 1213 days among these four groups. RESULTS: There were no significant differences in MACEs (10.4% in the short, 7.0% in the lower-medium, 6.5% in the upper-medium, 7.6% in the long, P=0.633) among the different stent length groups. The all-cause mortality, target lesion revascularization, and target vessel revascularization also did not differ among the four groups. In the drug-eluting stent (n=237) and bare-metal stent subgroups (n=449), all outcomes were comparable among the groups. However, in the diabetes subgroup (n=265), the rate of MACEs was higher in the long group than in the other groups, although the difference was not significant (6.6% in the short, 9.6% in the lower-medium, 3.4% in upper-medium, 16.7% in long group, P=0.095). CONCLUSION: A long stent length was not associated with adverse clinical outcomes in STEMI patients who underwent primary PCI.
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Fukutomi et al. (2019) conducted a cohort in ST-segment elevation myocardial infarction (STEMI) (n=686). Long stent length (≥32 mm) vs. Shorter stent lengths (<18 mm, 18-23 mm, 24-31 mm) was evaluated on Major adverse cardiovascular events (composite of cardiovascular death, myocardial infarction, and stroke after discharge) (p=0.633). Long stent length (≥32 mm) was not associated with increased major adverse cardiovascular events compared to short stents (<18 mm) in STEMI patients after primary PCI (7.6% vs 10.4%; P=0.633).
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