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Impact of stent length on clinical outcomes of first-generation and new-generation drug-eluting stents

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Abstract

The aim of this study is to compare first- and new-generation drug-eluting stents (DESs) which are implanted in long lesion. Stent length is known to be a predictor of adverse events after percutaneous coronary intervention (PCI), even with the first-generation DESs. The introduction of new-generation DESs has reduced the rates of adverse clinical events. However, the impact of stent length on long-term clinical outcomes is not well known. A total of 1181 consecutive patients who underwent PCI using either a first-generation DES (n = 885) or a new-generation DES (n = 296) between 2004 and 2011 were investigated. In each of the stent groups, the patients were divided into two groups by stent length (>32 and ≤32 mm) and compared. During the follow-up period, the incidence of major adverse cardiac events (MACEs) was significantly higher for patients with long stents implanted than with short stents (P < 0.01; log-rank test) in the first-generation DES group. However, there was no difference in the incidence of MACEs between the long- and short-stent groups in the new-generation DES group (P = 0.24; log-rank test). On multivariate Cox regression analysis, stent length was not associated with adverse events in the new-generation DES groups [hazard ratio (HR) 0.87; 95 % confidence interval (95 % CI) 0.71–1.04; P = 0.14]. Implanted stent length was significantly associated with a higher risk of MACEs in patients who received first-generation DESs, but not in patients who received the new-generation DESs.

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Acknowledgments

This study was supported by a grant-in aid for scientific research from the Ministry of Health, Labour and Welfare (23591063). The authors gratefully acknowledge Ms. Yumi Nozawa and Ms. Ayako Onodera for data collection and management.

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Authors and Affiliations

  1. Department of Cardiology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8431, Japan

    Hirokazu Konishi, Katsumi Miyauchi, Tomotaka Dohi, Shuta Tsuboi, Manabu Ogita, Ryo Naito, Takatoshi Kasai, Hiroshi Tamura, Shinya Okazaki, Kikuo Isoda & Hiroyuki Daida

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  1. Hirokazu Konishi
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  2. Katsumi Miyauchi
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  3. Tomotaka Dohi
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  11. Hiroyuki Daida
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Correspondence to Katsumi Miyauchi.

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Human rights statement

Ethics approval was obtained from Juntendo University ethics committee.

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Informed consent was obtained from all patients.

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There are no relationships with industry that could influence the impartiality of this study.

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Konishi, H., Miyauchi, K., Dohi, T. et al. Impact of stent length on clinical outcomes of first-generation and new-generation drug-eluting stents. Cardiovasc Interv and Ther 31, 114–121 (2016). https://doi.org/10.1007/s12928-015-0362-0

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  • DOI: https://doi.org/10.1007/s12928-015-0362-0

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