The relationship and threshold of stent length with regard to risk of stent thrombosis after drug-eluting stent implantation

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Abstract

Objectives: The aim of this study was to evaluate the association between the length of the stented segment and the risk of stent thrombosis (ST) after drug-eluting stent (DES) implantation and to determine the cutoff value of stent length in higher risk of ST in routine clinical practice. Background: Despite the recommendations of full lesion coverage to prevent angiographic restenosis, the length of the stented segment has been a risk factor for DES-related ST. Methods: A total of 3,145 consecutive patients (4,667 lesions) who underwent DES implantation were analyzed. The independent association of stent length with ST and its predictive value were evaluated for a median 29.6 months (interquartile range 21.6 to 37.5 months). Results: Stent thrombosis occurred in 68 patients (2.2%) at 3 years. The stent length/lesion was an independent predictor of ST (hazard ratio: 1.11, 95% confidence interval: 1.06 to 1.15, p < 0.001). The threshold of stent length for predicting ST was 31.5 mm (area under the receiver-operating characteristic curve: 0.746, 95% confidence interval: 0.699 to 0.793, p < 0.001), which had a sensitivity and specificity of 88.4% and 52.1%, respectively. Stent lengths <31.5 mm were associated with higher rates of ST (4.0% vs. 0.7%, p < 0.001), death (5.2% vs. 3.0%, p = 0.005), and myocardial infarction (2.4% vs. 0.7%, p = 0.001) at 3 years, as compared with stent lengths <31.5 mm. Conclusions: Length of the stented segment was independently associated with the incidence of ST and death or myocardial infarction after DES implantation. The value of stent length <31.5 mm is a threshold for the prediction of ST. © 2010 American College of Cardiology Foundation.

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Suh, J., Park, D. W., Lee, J. Y., Jung, I. H., Lee, S. W., Kim, Y. H., … Park, S. J. (2010). The relationship and threshold of stent length with regard to risk of stent thrombosis after drug-eluting stent implantation. JACC: Cardiovascular Interventions, 3(4), 383–389. https://doi.org/10.1016/j.jcin.2009.10.033

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