Key result
Increased stent length and number of implanted stents were significant predictors of non-improvement in left ventricular mechanical dyssynchrony 3 months after PCI (r=-0.509, p<0.001 for length).
Why the study?
To evaluate the short-term effect of stent size and number on left ventricular mechanical dyssynchrony following elective PCI to the LAD artery.
Do stent parameters (size and number) and clinical characteristics affect the improvement of left ventricular mechanical dyssynchrony after elective PCI to the LAD?
Cohort (n=150)
Do stent parameters (size and number) and clinical characteristics affect the improvement of left ventricular mechanical dyssynchrony after elective PCI to the LAD?
Increased stent length and number of stents during LAD PCI are associated with less improvement in left ventricular mechanical dyssynchrony, whereas stent diameter has no significant effect.
Answers are grounded in this paper and cite their sources.
Longer/more stents linked to less dyssynchrony improvement post-LAD PCI; hypothesis-generating and requires prospective validation before practice change.
Aim. To study short term effect of stent size and number on left ventricular mechanical dyssynchrony after elective percutaneous coronary intervention (PCI) to left anterior descending (LAD) artery. Materials and methods. the study included 150 adult patients with LAD lesion treated with PCI using drug-eluting stent. Patients were evaluated pre PCI then 1 month and 3 months post PCI for evaluation of mechanical dyssynchrony using tissue synchronization image (TSI). Results. Before revascularization mean left ventricular ejection fraction was 51.2±5.7 %, mean time to peak TSI was 213.6±10.9 ms; 1 month after PCI TSI improved significantly to 163.7±17.6 ms (p<0.001), 3 months after PCI showed more improvement to 120.7±26.9 ms (p<0.001). After 3m; 61 patients (40.7%) showed recovery to normal TSI value. The predictors of non-improvement of time to peak TSI after 3 months were diabetes mellitus (p=0.007), dyslipidemia (p=0.001) and stent length (p=0.001), number of stents (p=0.004). There were strong negative correlation between stent length and improvement of the time to peak TSI at 1 month (r=-0.352, p<0.001) and at 3 months (r=-0.509, p<0.001),and also with number of stent at 1 month (r= -0.173, p=0.034) and at 3 months (r=-0.499, p<0.001), but the correlation between stent diameter and improvement of the TSI wasn’t significant neither at 1 month nor at 3 months (r=0.055, p=0.504 and r= -0.018, p=0.827) respectively. Conclusion. Increased number and length of the implanted stents were predictors to non-improvement of mechanical dyssynchrony, while stent diameter didn’t affects the recovery.
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Mostafa et al. (2021) conducted a cohort in Left anterior descending (LAD) artery lesion (n=150). Stent length and number was evaluated on Improvement of time to peak tissue synchronization image (TSI) at 3 months (r=-0.509, p=<0.001). Increased stent length and number of implanted stents were significant predictors of non-improvement in left ventricular mechanical dyssynchrony 3 months after PCI (r=-0.509, p<0.001 for length).
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