Long-term clinical outcomes after drug eluting stent implantation with and without stent overlap.

Coughlan, J J; Aytekin, Alp; Koch, Tobias; Wiebe, Jens; Lenz, Tobias; Cassese, Salvatore; Joner, Michael; Koppara, Tobias; Xhepa, Erion; Ibrahim, Tareq; Fusaro, Massimiliano; Laugwitz, Karl-Ludwig; Schunkert, Heribert; Kastrati, Adnan; Kufner, Sebastian

doi:10.1002/ccd.29944

2022

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Document type:: Article; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
Author(s):: Coughlan, J J; Aytekin, Alp; Koch, Tobias; Wiebe, Jens; Lenz, Tobias; Cassese, Salvatore; Joner, Michael; Koppara, Tobias; Xhepa, Erion; Ibrahim, Tareq; Fusaro, Massimiliano; Laugwitz, Karl-Ludwig; Schunkert, Heribert; Kastrati, Adnan; Kufner, Sebastian
Title:: Long-term clinical outcomes after drug eluting stent implantation with and without stent overlap.
Abstract:: OBJECTIVE: The aim of this study was to investigate the impact of drug eluting stent (DES) overlap on clinical outcomes after percutaneous coronary intervention (PCI). BACKGROUND: While the use of overlapping bare metal stent has been associated with an increased risk of adverse clinical events, the long-term impact of DES overlap on clinical outcomes is not certain at present. Similarly, the effect of different DES generations and polymer types on DES overlap associated clinical outcomes has not previously been comprehensively elucidated. METHODS: We analyzed the angiographic and clinical outcomes of 5605 patients treated with DES in the setting of the ISAR-TEST 4 and ISAR-TEST 5 randomized control trials according to the presence or absence of stent overlap. The clinical endpoints assessed in this study were all-cause death, myocardial infarction (MI), target lesion revascularization (TLR), and definite or probable stent thrombosis at 10-years. We also compared rates of binary angiographic restenosis (BAR) at 6-8 months. RESULTS: At 10 years, all-cause mortality (Hazard ratios [HR] = 1.05 [0.95-1.16]; p = 0.348) did not differ between the stent overlap and no stent overlap groups. MI (8.4% vs. 5.2%; HR = 1.67 [1.35-2.07], p < 0.001) and TLR (23.7% vs. 16.3%; HR = 1.54 [1.36-1.74], p < 0.001) occurred more frequently in the stent overlap group. For MI, landmark analysis demonstrated that this increase in risk was primarily in the first 30 days post PCI. BAR at 6-8 months was also more frequent in the stent overlap group (16.0% vs. 10.3%; HR = 1.65 [1.41-1.92], p < 0.001). CONCLUSION: DES overlap is associated with an increased risk of adverse clinical events post PCI.
Journal title abbreviation:: Catheter Cardiovasc Interv
Year:: 2022
Journal volume:: 99
Journal issue:: 3
Pages contribution:: 541-551
Fulltext / DOI:: doi:10.1002/ccd.29944
Pubmed ID:: http://view.ncbi.nlm.nih.gov/pubmed/34487415
Print-ISSN:: 1522-1946
TUM Institution:: Klinik für Herz- und Kreislauferkrankungen im Erwachsenenalter (Prof. Schunkert); Klinik und Poliklinik für Innere Medizin I, Kardiologie
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mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Departments Clinical Medicine Klinik und Poliklinik für Innere Medizin I, Kardiologie (Prof. Laugwitz)2022

mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Departments Clinical Medicine Lehr- und Forschungskooperationen mit den Kliniken und Instituten am Deutschen Herzzentrum Klinik für Herz- und Kreislauferkrankungen im Erwachsenenalter (DHM) (Prof. Schunkert)2022