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Impact of drug eluting stents’ length and diameter on short term outcome in patients undergoing primary percutaneous coronary intervention Cover

Impact of drug eluting stents’ length and diameter on short term outcome in patients undergoing primary percutaneous coronary intervention

Romanian Journal of Cardiology
Volume 35 (2025): Issue 1 (March 2025)
By: ,  ,   and    
Open Access
|Mar 2025
Figures & tables

Figures & Tables

Table 1

Patients baseline and laboratory data (n=404)

Baseline dataN(%)
Age (years)
• Mean ± SD56.00 ± 11.35
• Range27 - 83
Gender, n (%)
• Male319(79.0)
• Female85(21.0)
Risk Factors, n (%)
• Diabetes126(30.7)
• Hypertension130(31.7)
• Smoking281(68.5)
• CVS8(2.0)
• Dyslipidemia117(29.0)
Killip classification
• I388(96.0)
• II16(4.0)
Pre-hospital delay (hours)6 (1 – 24)
Laboratory data
WBC(*103/ul)
• Mean ± SD12.13 ± 4.66
Hemoglobin (g/dl)
• Mean ± SD13.59 ± 1.87
Platelets (*103/ul)
• Mean ± SD287.04 ± 83.81
Triglyceride level (mg/dl)
• Mean ± SD135.06 ± 78.13
Cholesterol (mmol/L)
• Mean ± SD185.95 ± 46.44
LDL (mg/dl)
• Mean ± SD122.42 ± 37.89
HDL (mg/dl)
• Mean ± SD39.43 ± 8.68
Creatinine level (mg/dL)
At baseline
• Mean ± SD0.85 ± 0.27
After 48 hours of FU
• Mean ± SD0.91 ± 0.31
P value*<0.001

1 Quantitative data are presented as mean ± SD and range or median (range), qualitative data are presented as number (percentage).

1* P value for comparing the Creatinine level from baseline to after 48 hours of follow up. Significance defined by p < 0.05.

1 CVS: Cerebrovascular Stroke, WBC: White Blood Cells, LDL: Low Density Lipoprotein, HDL: High Density lipoprotein.

Table 2

Echocardiographic finding among the studied patients over the studied time points (before catheterization, during admission, and after 3 months

Electrocardiographic findingBefore catheterization, n=404During admission, n=401After 3 months, n=381P value
EF (%)49 (25 – 65)51 (26 – 67)54 (25 – 68)<0.001
MR0.001
• No335(82.9)333(83.0)334(87.7)
• Yes69(17.1)68(17.0)47(12.3)
SWMA<0.001
• Absent0(0.0)12(3.0)52(13.6)
• Present404(100.0)389(97.0)329(86.4)
Score index, median (range)1.4 (1.08 – 2.3)1.4 (1.0 – 2.3)1.2 (1.0 – 2.3)<0.001
Diastolic dysfunction<0.001
404(100.0)400(99.8)371(97.4)

1 Quantitative data are presented as median (range), and qualitative data are presented as number (percentage). * Significance defined by p < 0.05. EF: ejection fraction, MR: mitral regurge, SWMA: segmental wall motion abnormality.

Table 3

Angiographic characteristics of the studied patients in different stent length groups (n=404)

Angiographic characteristics< 20 (n=40)Stent length 20 – 40 (n=295)> 40 (n=69)P value
Access site
•Femoral37(92.5)275(93.2)63(91.3)0.768
•Radial3(7.5)20(6.8)6(8.7)
Target vessel<0.001
• LAD16(40.0)190(64.4)47(68.1)
• RCA8(20.0)82(27.8)19(27.5)
• LCX13(32.5)16(5.4)3(4.3)
• Other coronary branches3(7.5)7(2.4)0(0.0)
Pre TIMI flow0.141
• TIMI flow grades ≤224(60.0)217(73.6)46(66.7)
• TIMI flow grade 316(40.0)78(26.4)23(33.3)
Final TIMI flow0.016
• TIMI flow grades ≤ 2 (SF-NR)1(2.5)12(4.1)9(13.0)
• TIMI flow grade 339(97.5)283(95.9)60(87.0)
No. of affected vessels0.211
• 127(67.5)197(66.8)43(62.3)
• 212(30.0)98(33.2)26(37.7)
• 31(2.5)0(0.0)0(0.0)
Pre-dilatation23(57.5)200(67.8)53(76.8)0.105
• Median No. of pre-dilatation1 (0 – 4)1 (0 – 6)2 (0 – 16)0.010
Post – dilatation7(17.5)55(18.6)20(29.0)0.141
• Median No. of post-dilatation0 (0 – 3)0 (0 – 7)0 (0 – 5)0.129
Side branches occlusion0(0.0)8(2.7)1(1.4)0.863
Thrombus burden grades0.373
• Grade 00(0.0)2(0.7)0(0.0)
• Grade 12(5.0)7(2.4)5(7.2)
• Grade 23(7.5)9(3.1)1(1.4)
• Grade 36(15.0)47(15.9)14(20.3)
• Grade 45(12.5)39(13.2)5(7.2)
• Grade 524(60.0)191(64.7)44(63.8)
Median door to device in minutes (range)30 (15 – 110)30 (12 – 110)35 (15 – 90)0.011
Median onset of chest pain to wire in hours (range)5 (2 – 18)6.5 (1.5 – 95.0)8 (2 – 24)<0.001
Mean procedure time in minutes26.30 ± 6.8127.09 ± 6.8636.84 ± 8.88<0.001
Mean contrast amount in ml123.50 ± 29.31120.88 ± 23.97131.16 ± 31.790.013

1 Quantitative data are presented as median (range), and qualitative data are presented as number (percentage). * Significance defined by p < 0.05. LAD: left anterior descending, RCA: right coronary artery, LCX: left circumflex, TIMI: thrombolysis in myocardial infarction, SF-NR: slow flow –no reflow.

Figure 1

In hospital MACEs among the studied patients in different stent length groups, AF: atrial fibrillation, CVS: cerebrovascular stroke, HF: heart failure

Figure 2

Three months’ follow up of MACEs among the studied patients in different stent length groups. ACS: acute coronary syndrome, AF: atrial fibrillation, CVS: cerebrovascular stroke, HF: heart failure.

Table 4

Angiographic characteristics of the studied patients in different stent diameter groups (n=404)

Angiographic characteristics< 3.0 (n=62)Stent diameter 3.0 – 3.5 (n=306)> 3.5 (n=36)P value
Access site
•Femoral56(90.3)284(92.8)35(97.2)0.503
•Radial6(9.7)22(7.2)1(2.8)
Target vessel<0.001
• LAD31(50.0)205(67.0)17(47.2)
• LCX14(22.6)78(25.5)17(47.2)
• RCA9(14.5)21(6.9)2(5.6)
• other coronary branches8(12.9)2(0.6)0(0.0)
Pre TIMI flow0.181
• TIMI flow grades ≤250(80.6)213(69.6)24(66.7)
• TIMI flow grade 312(19.4)93(30.4)12(33.3)
Final TIMI flow0.590
• TIMI flow grades ≤25(8.1)16(5.2)1(2.8)
• TIMI flow grade 357(91.9)290(94.8)35(97.2)
No. of affected vessels0.194
• 134(54.8)206(67.3)27(75.0)
• 228(45.2)99(32.4)9(25.0)
• 30(0.0)1(0.3)0(0.0)
Pre-dilatation54(87.1)200(65.4)22(61.1)0.002
• Median No. of pre-dilatation2 (0 – 10)1 (0 – 16)1 (0 – 4)<0.001
Post – dilatation17(27.4)57(18.6)8(22.2)0.279
• Median No. of post-dilatation0 (0 – 6)0 (0 – 7)0 (0 – 3)0.356
Side branches occlusion0(0.0)6(2.0)3(8.3)0.042
Thrombus burden grades0.071
• Grade 00(0.0)1(0.3)1(2.8)
• Grade 14(6.5)9(2.9)1(2.8)
• Grade 20(0.0)10(3.3)3(8.3)
• Grade 38(12.9)53(17.3)6(16.7)
• Grade 43(4.8)41(13.4)5(13.9)
• Grade 547(75.8)192(62.7)20(55.6)
▪Low13(27.7)65(33.9)2(10.0)0.078
▪High34(72.3)127(66.1)18(90.0)
SF-NR5(8.1)16(5.2)1(2.8)0.590
Median door to device time in minutes (range)33 (15 – 90)30 (12 – 110)30 (20 – 80)0.740
Median onset of chest pain to wire in hours (range)6.5 (2 – 24)6.5 (1.5 – 95.0)5.5 (3 – 24)0.416
Mean procedure time in minutes32.19 ± 9.9428.31 ± 7.7525.72 ± 5.67<0.001
Mean contrast amount in ml126.13 ± 26.94122.68 ± 26.46119.17 ± 22.730.430

1 Quantitative data are presented as median (range), and qualitative data are presented as number (percentage). * Significance defined by p < 0.05. LAD: left anterior descending, RCA: right coronary artery, LCX: left circumflex, TIMI: thrombolysis in myocardial infarction, SF-NR: slow flow –no reflow.

Figure 3

In hospital follow up of MACEs among the studied patients according to the stent diameter. AF: atrial fibrillation, CVS: cerebrovascular stroke, HF: heart failure.

Figure 4

Three months’ follow up of MACEs among the studied patients in different stent diameter groups. ACS: acute coronary syndrome, AF: atrial fibrillation, CVS: cerebrovascular stroke. HF: heart failure.

Table 5

Univariate and Multivariate logistic regression analysis for prediction of SF-NR among studied patients

VariablesUnivariate analysisMultivariate analysis
OR95% CIP valueOR95% CIP value
Killip classification
• Irefref
• II4.4821.177 – 17.0710.0282.6010.560 – 12.0840.223
No. of pre-dilatation1.5971.266 – 2.014<0.0011.4861.182 – 1.8690.001
Procedure time1.1031.053 – 1.155<0.0011.0731.016 – 1.1330.011
EF (%)0.9020.850 – 0.9560.0010.9260.856 – 1.0010.054
Diastolic dysfunction grade
• Grade 1refref
• Grade 25.8912.435 – 14.249<0.0012.4780.778 – 7.8980.125
• Grade 30.0000.00 - NA0.9990.000.00 - NA1.00

1 CI: Confidence interval; OR: Odds ratio; NA: not achieved. * P value is significant £0.05 EF: ejection fraction.

Table 6

Univariate and Multivariate logistic regression analysis for prediction of MACEs among studied patients

VariablesUnivariate analysisMultivariate analysis
OR95% CIP valueOR95% CIP value
Killip classification
• Irefref
• II10.8682.436 – 48.4930.0027.2001.555 – 33.3370.012
Pre-hospital delay (hour)1.0491.008 – 1.0920.0181.0280.984 – 1.0730.219
Door to device time1.0171.003 – 1.0310.0181.0110.997 – 1.0260.130
Final TIMI flow
• TIMI flow grades ≤21.6741.066 – 2.6290.0251.2620.769 – 2.0730.358
• TIMI flow grade 3ref
No. of pre-dilatation1.1721.029 – 1.3360.0171.0820.943 – 1.2420.259
  Side branches occlusion
• Noref
• Yes5.1951.065 – 25.3300.0423.8310.731 – 20.0690.112
Procedure time1.0411.015 – 1.0670.0021.0301.002 – 1.0600.036
EF (%)0.9680.943 – 0.9930.0120.9870.958 – 1.0180.412
Diastolic dysfunction grade
• Grade 1refref
• Grade 21.8921.112 – 3.2210.0191.2440.673 – 2.3000.485
• Grade 30.000.00 - NA0.9990.000.00 - NA1.00

1 CI: Confidence interval; OR: Odds ratio; NA: not achieved. * P value is significant 0.05. TIMI: thrombolysis in myocardial infarction, EF: ejection fraction.

DOI: https://doi.org/10.2478/rjc-2024-0027 | Journal eISSN: 2734-6382 | Journal ISSN: 1220-658X
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Language: English, Romanian
Page range: 26 - 35
Published on: Mar 31, 2025
Published by: Romanian Society of Cardiology
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year
Keywords:
second generation coronary stent,
ST segment elevation myocardial infarction,
primary percutaneous coronary intervention,
slow flow/no-reflow,
major adverse cardiovascular events
Related subjects:
Medicine,
Clinical medicine,
Internal medicine,
Cardiology,
Pediatrics and juvenile medicine,
Paediatric cardiology,
Surgery,
Cardiac surgery

© 2025 Ahmed Abdel-Galeel, Nada Deyaa-eldeen, Doaa Ahmed Fouad, Marwan S. Mahmoud, published by Romanian Society of Cardiology
This work is licensed under the Creative Commons Attribution 4.0 License.

Volume 35 (2025): Issue 1 (March 2025)
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