Association of stent diameter and target vessel revascularization in patients undergoing percutaneous coronary intervention: a secondary retrospective analysis based on a Chinese cohort study

Tiancheng Xu; Beili Feng; Zaixing Zheng; Licheng Li; Weifang Zeng; Dongjuan Wang; Lin Zhang; Hengdong Li

doi:10.1186/s12872-021-02212-1

Association of stent diameter and target vessel revascularization in patients undergoing percutaneous coronary intervention: a secondary retrospective analysis based on a Chinese cohort study

BMC Cardiovasc Disord. 2021 Aug 21;21(1):402. doi: 10.1186/s12872-021-02212-1.

Authors

Tiancheng Xu^{1

2}, Beili Feng^{1

2}, Zaixing Zheng^{1

2}, Licheng Li^{1

2}, Weifang Zeng^{1

2}, Dongjuan Wang^{1

2}, Lin Zhang^{1

2}, Hengdong Li^{3

4}

Affiliations

¹ Department of Cardiology, Hwa Mei Hospital, University of Chinese Academy of Sciences, No. 41 Northwest Street, Haishu District, Ningbo, 315000, Zhejiang, China.
² Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, 315000, Zhejiang, China.
³ Department of Cardiology, Hwa Mei Hospital, University of Chinese Academy of Sciences, No. 41 Northwest Street, Haishu District, Ningbo, 315000, Zhejiang, China. lhdlhdlhdd@163.com.
⁴ Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, 315000, Zhejiang, China. lhdlhdlhdd@163.com.

Abstract

Background: In the treatment of coronary heart disease, target vessel revascularization (TVR) has attracted increasing attention as an efficient means of percutaneous coronary intervention (PCI). The purpose of this study was to explore the association between stent diameter and TVR in patients undergoing PCI.

Methods: This was a secondary retrospective analysis involving patients with PCI with at least one stent implanted. Information was obtained from the Dryad Digital Repository. Multivariable logistic regression models, interaction analyses, subgroup analyses and piecewise linear regression models were used to evaluate the association between stent diameter and TVR.

Results: A total of 2522 patients were eventually enrolled in this study, of which 122 (4.8%) had undergone TVR. Significant positive associations were observed between stent diameter and TVR (continuous: odds ratio [OR] 0.485, 95% confidence interval [CI] 0.305-0.773, P = 0.002; categorical variable: T2 vs. T1, OR 0.541, 95% CI 0.348-0.843; T3 vs. T1, OR 0.520, 95% CI 0.334-0.809; P for trend = 0.005). The association remained stable in the fully adjusted model (continuous: OR 0.526, 95% CI 0.306-0.902, P = 0.020; categorical variable: T2 vs. T1, OR 0.510, 95% CI 0.310-0.839; T3 vs. T1, OR 0.585, 95% CI 0.352-0.973; P for trend = 0.042). Among the subgroups of differing clinical presentations, stent diameter was a powerful protective factor for TVR, especially in the delayed PCI group (P for interaction = 0.002). The association was highly consistent across all the other subgroups studied (all P for interaction > 0.05). In the piecewise linear regression model, the need for TVR decreased with an increase in stent diameter when this ranged between 2.5 and 2.9 mm (OR 0.01, 95% CI: 0.01-0.13, P < 0.001).

Conclusions: A large stent diameter is a powerful protective factor for TVR in PCI patients, especially in the delayed PCI group. This "bigger-is-better" protective effect is remarkable in stents with diameter 2.5-2.9 mm.

Keywords: Percutaneous coronary intervention; Stent diameter; Target vessel revascularization.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
China
Coronary Disease / diagnostic imaging
Coronary Disease / therapy*
Female
Humans
Male
Middle Aged
Percutaneous Coronary Intervention / adverse effects
Percutaneous Coronary Intervention / instrumentation*
Prosthesis Design
Protective Factors
Retrospective Studies
Risk Assessment
Risk Factors
Stents*
Time Factors
Treatment Outcome