Background: Stent overlapping was associated with adverse clinical outcomes and inreased target lesion revasularization (TLR) after percutaneous coronary intervention (PCI) using bare-metal stents. However, there are conflicting data regard the impact of stent overlapping in the era of second generation drug-eluting stents (DES). The aim of this study is to assess the impact of stent overlapping on long-term clinical outcomes following PCI with second-generation DESs.
Methods: A total of 472 patients with 899 de novo coronary lesions underwent PCI with second generation DESs were divided into two groups acording to the presence of the stent overalap: 1) Single stent group (n:747), 2) overlapping stent group (n:152). To adjust any potential confounders, a propensity score matching (PSM) analysis was performed using the logistic regression model. Major adverse cardiac events (MACE), the composite of total death, myocardial infarction, stroke and revascularization, were compared between the two groups up to 5 years.
Results: After PSM analysis, two propensity score-matched groups (94 pairs, n=188) were generated with balanced baseline clinical and angiographic characteristics. The overlapping stent group had a higher incidence of TLR (HR 1.97; 95 % CI: 1.08-3.85; P:0.04) and target vessel revascularization (TVR, HR 1.59; 95 % CI: 1.07-3.56; P:0.02). However, there was no significant difference in the incidence of mortality, myocardial infarction and total MACE between the two groups up to 5 years (Table).
Conclusions: In this study, stent overlapping with second genration DESs was associated with higher incidence of TLR and TVR but was not associated with increased mortality, myocardial infarction and total MACE.