Abstract 17263: Comparison of Full Coverage Versus Spot Drug-Eluting Stenting for De Novo Coronary Artery Stenoses at 12-month Follow-up: Subgroup Analysis from The RESET Trial
Background: In the Drug-eluting stents era, the introduction of drug-eluting stents has resulted in the use of longer or multiple, overlapping drug-eluting stents in patients with diffusely diseased coronary arteries and drug-eluting stenting of long lesions is currently considered an on-label indication, and it has been considered a suitable approach in clinical practice. However, stent length, number of stents, and the use of overlapping stents have all been associated with an increased risk of restenosis, stent fracture, and thrombosis, and recently, some studies reported that short-term and long-term risk for MACEs was lower among patients with spot DES stenting compared to those who underwent full DES coverage.
Objectives: The purpose of this study was to evaluate whether spot DES stenting might result in superior clinical outcomes at 1-year compared with full DES coverage in treatment of patient with de novo coronary artery stenoses.
Methods: We analyzed 1,619 patients with a de novo coronary lesion of consecutive nonuniform severity who was indicated for percutaneous coronary intervention from RESET registry between May 2009 and December 2010. They were divided into 2 groups which were treated by full cover strategy or spot stenting strategy (full coverage group n= 1200; spot stenting group n= 419). The primary endpoint was the composite of 1-year target vessel failure (TVF), including cardiac death, target-vessel myocardial infarction, or ischemia-driven target-lesion revascularization.
Results: Spot DES stenting were superior to full DES coverage with respect to the primary end point of 1-year target vessel failure (1.4% vs. 3.3%, p=0.044). Cox proportional hazard model showed that the risk for TVF was almost 58% lower among patients who were subjected to spot DES stenting compared to those who underwent full DES coverage (HR=0.42, 95% CI=0.18-0.99, P = 0.048).This association remained significant even after controlling for other risk factors including age, hypertension, lesion length, the type of stent used and so on (HR=0.41, 95% CI=0.17-0.99; P = 0.048).
Conclusion: Minimizing the stent length by spot DES stenting, as compared with full DES coverage, resulted in reduced rates of target-lesion failure at 1 year.
- © 2012 by American Heart Association, Inc.