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Underestimation of Stent Efficacy: Untreated Artery Events Distort Coronary Intervention Outcomes

Mauricio Rigodanzo Mocha1, Whady Hueb1, Paulo Cury Rezende1

  • 1Divisão Clinica, Instituto do Coracao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, BR.

Clinical Cardiology
|December 5, 2025
PubMed

Insights

Evaluating percutaneous coronary intervention (PCI) effectiveness requires assessing event location. Many coronary events occur outside the treated site, suggesting isolated evaluation of treated sites offers a more accurate measure of stent performance.

Area of Science:

  • Cardiovascular medicine
  • Interventional cardiology
  • Biomedical engineering

Background:

  • Percutaneous coronary intervention (PCI) effectiveness is often assessed by overall coronary events.
  • The specific location of these events within the coronary vasculature is frequently overlooked.
  • This study addresses the need to analyze event location relative to treated sites.

Purpose of the Study:

  • To evaluate the incidence of coronary events after PCI.
  • To investigate the correlation between coronary events and their location within the treated site.
  • To examine the relationship between event location and stent type used.

Main Methods:

  • Retrospective cohort analysis of stable coronary artery disease (CAD) patients undergoing PCI.
  • Comparison of conventional versus drug-eluting stents.
  • Event location determined by angiography using data from the MASS Clinical Research Unit database.

Main Results:

  • 232 out of 562 patients (41.3%) experienced coronary events.
  • 55.8% of events occurred at the treated site; 44.2% occurred at untreated sites.
  • No significant association found between treated site events and stent type (p=0.363).

Conclusions:

  • A substantial proportion of coronary events occur in sites not treated by PCI.
  • Focusing solely on the treated site may yield a more precise evaluation of stent effectiveness.
  • This highlights the importance of location-specific analysis in PCI outcome studies.
Abstract

Keywords:
angioplastycardiovascular eventspercutaneous coronary interventionstable coronary artery disease

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