Author + information
- Received October 21, 2009
- Accepted October 29, 2009
- Published online April 1, 2010.
- Jon Suh, MD⁎,
- Duk-Woo Park, MD, PhD†,
- Jong-Young Lee, MD†,
- In Hyun Jung, MD†,
- Seung-Whan Lee, MD, PhD†,
- Young-Hak Kim, MD, PhD†,
- Cheol Whan Lee, MD, PhD†,
- Sang-Sig Cheong, MD, PhD‡,
- Jae-Joong Kim, MD, PhD†,
- Seong-Wook Park, MD, PhD† and
- Seung-Jung Park, MD, PhD†,⁎ ()
- ↵⁎Reprint requests and correspondence:
Dr. Seung-Jung Park, Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Cardiac Center, 388-1 Poongnap-dong, Songpa-gu, Seoul 138-736, Korea
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.
This study was supported by the Cardiovascular Research Foundation (Korea) and a grant from the Korean Ministry of Health and Welfare as part of the Korea Health 21 Research and Development Project (0412-CR02-0704-0001).
- Received October 21, 2009.
- Accepted October 29, 2009.
- American College of Cardiology Foundation