Author + information
To determine the impact of stent length on clinical outcomes of everolimus-eluting stents (EES) vs. paclitaxel-eluting stents (PES) in the TUXEDO (Taxus Element versus Xience Prime in a Diabetic Population)-India trial at 1-year of follow-up.
In the TUXEDO-India trial, the target lesion data was available for 1,801 of 1,830 diabetic patients undergoing percutaneous coronary intervention. The total stent length was calculated as a summation of the length of all stents implanted in a given patient and was broadly categorized into two sub-groups: <20 mm and ≥ 20 mm stent lengths. Comparisons were done between the stent length subgroups and the stent type. Chi-square/Fisher’s exact test was used to calculate P-values of categorical data and T-test for continuous data. Multivariable predictor analysis was used to predict the effect of stent length and stent type on TVF, TVR andST using logistic regression method.
Out of 1,801 patients, 454 (25%) patients (EES: 272; PES: 182) received stent/s of total length <20 mm and 1,347 (75%) patients (EES: 632; PES: 715) received stent/s of total length ≥20 mm. Both the subgroups were comparable in terms of baseline characteristics except mean target lesions/patient; which was found to be significantly higher in the patients receiving stent length ≥20 mm compared to the other subgroup (1.39 ± 0.58 vs. 1.00 ± 0.00; p<0.0001). The proportion of patients with TVF (5.87% vs. 3.16%; p=0.0179), MI (3.5% vs. 1.58%, p=0.0275), target vessel-related MI (3.08% vs.0.79%, p=0.0028), ST (2.38% vs 0.63%, p=0.0099), TLR (3.64% vs 1.42%, p=0.0109) and TVR (3.64% vs 1.42%, p=0.0109) was significantly higher in the PES group compared to the EES group implanted with stent length ≥20 mm. There were no significant differences in the groups with stent length <20 mm. As per multivariable predictor analysis, stent length was not a statistically significant predictor while stent type was a statistically significant predictor of TVF, TVR, and ST.
In our multicentric prospective trial, stent length was not a statistically significant predictor of TVF, TVR, and ST. In contrast, longer stent lengths were associated with worse clinical outcomes in the PES group compared to the EES group.