E-2 | Bempedoic Acid Use Following Drug-Eluting Stent Implantation and Cardiovascular Outcomes: A Propensity-Matched Analysis From a Global Federated Health Network

Background: Chronic total occlusion (CTO) percutaneous coronary intervention (PCI) is a complex and high-risk procedure that requires greater procedure times, radiation exposure, and contrast use compared to normal PCI.Despite improvement in procedural techniques, stent length, a potential marker of lesion complexity, may also influence post-procedure outcomes.We investigate whether cumulative stent length is associated with adverse clinical outcomes in patients undergoing CTO PCI using real-world data from a high-volume tertiary care center.Methods: We conducted a retrospective analysis of adults who underwent CTO PCI at a cardiac center between January 2018 and December 2022.Patients were stratified into short (8-48 mm) or long (50-128 mm) total stent length groups.The primary endpoints were major adverse cardiovascular events (MACE), target lesion revascularization (TLR) and all-cause mortality (ACM) at follow-up.Results: Patients with long stent length exhibited greater procedure times (103 vs 85 min, p < 0.001), higher fluoroscopy times (median 36.0 vs 27.7 min, p < 0.001), and greater contrast volume use (230 vs 200 mL, p = 0.009) compared to patients with short stent length.There were similar incidence rates of MACE ( 87vs 101 per 1000 person years), TLR (21 vs 29 per 1000 person years), and all-cause mortality (21 vs 30 per 1000 person years) at a follow-up of 2.21 years.(Figure) Conclusions: Stent length was not associated with any difference in MACE, TLR, or ACM after successful CTO PCI, suggesting clinical prognosis is similar regardless of stent length and highlighting the importance of technical operator skill and patient selection over stent.