Background
Patients with lesions located in small vessels are at increased risk of adverse outcomes after PCI. Improved safety and efficacy have been previously demonstrated with XIENCE V stents in relatively low-risk populations with small vessel disease in SPIRIT trials. The objective of this analysis is to evaluate the 1-year clinical outcomes of more complex patients with smaller vessels treated with XIENCE V from XIENCE V USA, a large, prospective, real-world study.
Methods
The XIENCE V stent used in the study ranged from 2.5 to 4.0 mm in diameter. Baseline and 1-year clinical outcomes were compared between patients who had at least one 2.5-mm stent implanted (the smaller vessel cohort, n =1869) and those who were implanted with stents >2.5 mm in diameter (the non-small vessel cohort, n =2905). Events were adjudicated by an independent committee.
Methods
The XIENCE V stent used in the study ranged from 2.5 to 4.0 mm in diameter. Baseline and 1-year clinical outcomes were compared between patients who had at least one 2.5-mm stent implanted (the smaller vessel cohort, n =1869) and those who were implanted with stents >2.5 mm in diameter (the non-small vessel cohort, n =2905). Events were adjudicated by an independent committee.
Results
A total of 2245 lesions were treated with 2.5-mm stents with a mean reference vessel diameter of 2.57 mm in the smaller vessel cohort. Compared to the non-small vessel cohort, the smaller vessel cohort consisted of more females and presented with more diabetes, hypertension, and recent MI. They also had more bifurcation and chronic total occluded lesions, but less restenotic lesions. There were more lesions treated and more stents implanted per lesion in the smaller vessel cohort. Table 1 shows the clinical outcomes.
| 1-year event rate | Smaller vessel cohort ( n =1869) | Non-small vessel cohort ( n =2905) | P value a |
|---|---|---|---|
| Cardiac death and MI b | 6.7% | 5.9% | 0.26 |
| Target lesion failure (TLF): cardiac death, target vessel MI b , clinically indicated TLR | 9.0% | 7.8% | 0.13 |
| Cardiac death | 1.6% | 1.5% | 0.90 |
| MI b | 5.6% | 4.9% | 0.28 |
| TLR | 5.1% | 3.9% | 0.04 |
| TVR, non-TLR | 2.5% | 2.0% | 0.31 |
| ARC-defined stent thrombosis (definite/probable) | 1.11% | 0.64% | 0.10 |
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