Severe acute stent malapposition was not associated with significant differences in long-term clinical outcomes at 5 years in patients with drug-eluting stents.
Does severe acute stent malapposition after drug-eluting stent implantation increase the risk of long-term composite clinical events in patients undergoing PCI?
Severe acute stent malapposition detected by OCT after drug-eluting stent implantation does not appear to worsen long-term clinical outcomes at 5 years.
Absolute Event Rate: 0% vs 0%
Background The effects of severe acute stent malapposition ( ASM ) after drug‐eluting stent implantation on long‐term clinical outcomes are not clearly understood. We evaluated long‐term clinical outcomes of severe ASM using optical coherence tomography. Methods and Results We pooled patient‐ and lesion‐level data from 6 randomized studies. Five studies investigated follow‐up drug‐eluting stent strut coverage and one investigated ASM . In this data set, a total of 436 patients with 444 lesions underwent postintervention optical coherence tomography examination and these data were included in the analysis. Severe ASM was defined as lesions with ≥400 μm of maximum malapposed distance or ≥1 mm of maximum malapposed length. Composite events (cardiac death, target lesion–related myocardial infarction, target lesion revascularization, and stent thrombosis) were compared between patients with and without severe ASM . The postintervention optical coherence tomography findings indicated that 62 (14.2%) patients had lesions with ≥400 μm of maximum malapposed distance and 186 (42.7%) patients had lesions with ≥1 mm of maximum malapposed length. The 5‐year clinical follow‐up was completed in 371 (86.1%) of the eligible 431 patients. The cumulative rate of composite events was similar among the patients in each group during 5‐year follow‐up: 3.3% in patients with ASM ≥400 μm of maximum malapposed distance versus 3.1% in those with no ASM or ASM <400 μm of maximum malapposed distance ( P =0.89), and 1.2% in patients with ASM ≥1 mm of maximum malapposed length versus 4.6% in those with no ASM or ASM <1 mm of maximum malapposed length ( P =0.06). Conclusions During the 5‐year follow‐up, ASM severity was not associated with long‐term clinical outcomes in patients treated with drug‐eluting stents.
Lee et al. (Tue,) reported a other. Severe acute stent malapposition was not associated with significant differences in long-term clinical outcomes at 5 years in patients with drug-eluting stents.