TY - JOUR
T1 - Effect of Increasing Stent Length on 3-Year Clinical Outcomes in Women Undergoing Percutaneous Coronary Intervention With New-Generation Drug-Eluting Stents
T2 - Patient-Level Pooled Analysis of Randomized Trials From the WIN-DES Initiative
AU - Chandrasekhar, Jaya
AU - Baber, Usman
AU - Sartori, Samantha
AU - Stefanini, Giulio G.
AU - Sarin, Michele
AU - Vogel, Birgit
AU - Farhan, Serdar
AU - Camenzind, Edoardo
AU - Leon, Martin B.
AU - Stone, Gregg W.
AU - Serruys, Patrick W.
AU - Wijns, William
AU - Steg, Philippe G.
AU - Weisz, Giora
AU - Chieffo, Alaide
AU - Kastrati, Adnan
AU - Windecker, Stephan
AU - Morice, Marie-Claude
AU - Smits, Pieter C.
AU - von Birgelen, Clemens
AU - Mikhail, Ghada W.
AU - Itchhaporia, Dipti
AU - Mehta, Laxmi
AU - Kim, Hyo-Soo
AU - Valgimigli, Marco
AU - Jeger, Raban V.
AU - Kimura, Takeshi
AU - Galatius, Søren
AU - Kandzari, David E.
AU - Dangas, George D.
AU - Mehran, Roxana
PY - 2018/1/8
Y1 - 2018/1/8
N2 - Objectives: The aim of this study was to examine whether stent length per patient and stent length per lesion are negative markers for 3-year outcomes in women following percutaneous coronary intervention (PCI) with new-generation drug-eluting stents (DES).Background: In the era of advanced stent technologies, whether stent length remains a correlate of adverse outcomes is unclear.Methods: Women treated with new-generation DES in 14 randomized trials from the WIN-DES (Women in Innovation and Drug-Eluting Stents) pooled database were evaluated. Total stent length per patient, which was available in 5,403 women (quartile 1, 8 to 18 mm; quartile 2, 18 to 24 mm; quartile 3, 24 to 36 mm; quartile 4, ≥36 mm), and stent length per lesion, which was available in 5,232 women (quartile 1, 8 to 18 mm; quartile 2, 18 to 20 mm; quartile 3, 20 to 27 mm; quartile 4, ≥27 mm) were analyzed in quartiles. The primary endpoint was 3-year major adverse cardiovascular events (MACE), defined as a composite of all-cause death, myocardial infarction, or target lesion revascularization.Results: In the per-patient analysis, a stepwise increase was observed with increasing stent length in the adjusted risk for 3-year MACE (p for trend <0.0001), myocardial infarction (p for trend <0.001), cardiac death (p for trend = 0.038), and target lesion revascularization (p for trend = 0.011) but not definite or probable stent thrombosis (p for trend = 0.673). In the per-lesion analysis, an increase was observed in the adjusted risk for 3-year MACE (p for trend = 0.002) and myocardial infarction (p for trend <0.0001) but not other individual endpoints. On landmark analysis for late event rates between 1 and 3 years, stent length per patient demonstrated weak associations with target lesion revascularization (p = 0.0131) and MACE (p = 0.0499), whereas stent length per lesion was not associated with higher risk for any late events, suggesting that risk was established early within the first year after PCI.Conclusions: In this pooled analysis of women undergoing PCI with new-generation DES, increasing stent length per patient and per lesion were independent predictors of 3-year MACE but were not associated with definite or probable stent thrombosis.
AB - Objectives: The aim of this study was to examine whether stent length per patient and stent length per lesion are negative markers for 3-year outcomes in women following percutaneous coronary intervention (PCI) with new-generation drug-eluting stents (DES).Background: In the era of advanced stent technologies, whether stent length remains a correlate of adverse outcomes is unclear.Methods: Women treated with new-generation DES in 14 randomized trials from the WIN-DES (Women in Innovation and Drug-Eluting Stents) pooled database were evaluated. Total stent length per patient, which was available in 5,403 women (quartile 1, 8 to 18 mm; quartile 2, 18 to 24 mm; quartile 3, 24 to 36 mm; quartile 4, ≥36 mm), and stent length per lesion, which was available in 5,232 women (quartile 1, 8 to 18 mm; quartile 2, 18 to 20 mm; quartile 3, 20 to 27 mm; quartile 4, ≥27 mm) were analyzed in quartiles. The primary endpoint was 3-year major adverse cardiovascular events (MACE), defined as a composite of all-cause death, myocardial infarction, or target lesion revascularization.Results: In the per-patient analysis, a stepwise increase was observed with increasing stent length in the adjusted risk for 3-year MACE (p for trend <0.0001), myocardial infarction (p for trend <0.001), cardiac death (p for trend = 0.038), and target lesion revascularization (p for trend = 0.011) but not definite or probable stent thrombosis (p for trend = 0.673). In the per-lesion analysis, an increase was observed in the adjusted risk for 3-year MACE (p for trend = 0.002) and myocardial infarction (p for trend <0.0001) but not other individual endpoints. On landmark analysis for late event rates between 1 and 3 years, stent length per patient demonstrated weak associations with target lesion revascularization (p = 0.0131) and MACE (p = 0.0499), whereas stent length per lesion was not associated with higher risk for any late events, suggesting that risk was established early within the first year after PCI.Conclusions: In this pooled analysis of women undergoing PCI with new-generation DES, increasing stent length per patient and per lesion were independent predictors of 3-year MACE but were not associated with definite or probable stent thrombosis.
KW - New-generation drug-eluting stents
KW - Patient-level pooled analysis of women
KW - Percutaneous coronary intervention
KW - Stent length per lesion
KW - Stent length per patient
KW - n/a OA procedure
UR - http://www.scopus.com/inward/record.url?scp=85039959314&partnerID=8YFLogxK
U2 - 10.1016/j.jcin.2017.11.020
DO - 10.1016/j.jcin.2017.11.020
M3 - Article
AN - SCOPUS:85039959314
SN - 1936-8798
VL - 11
SP - 53
EP - 65
JO - JACC : cardiovascular interventions
JF - JACC : cardiovascular interventions
IS - 1
ER -
