Contemporary clinical characteristics, treatment, and outcomes of angiographically confirmed coronary stent thrombosis: Results from a multicenter California registry

Khung Keong Yeo, Ehtisham Mahmud, Ehrin J. Armstrong, William E. Bennett, Kendrick A. Shunk, John S. MacGregor, Zhongmin Li, Reginald Low, Jason H Rogers

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Objectives: To describe the contemporary treatment and outcomes for patients with angiographically confirmed (definite) stent thrombosis (ST). Background: Limited data are available on contemporary treatment patterns and outcomes of patients with ST in the United States. Methods: In this multicenter California registry, consecutive cases of definite ST over 5 years were identified. Clinical characteristics, in-hospital outcomes, and long-term survival are reported. Results: One hundred and sixty five consecutive episodes of ST were identified in 153 patients from January 2005 to February 2010. The distribution of acute (≤24 hr), subacute (24 hr to 30 days), late (30 days to 1 year), and very late (âyen1 year) ST was 3.9%, 21.8%, 17.6%, and 50.3%, respectively. Only 41.2% of patients were on dual antiplatelet therapy at the time of presentation, while 22.4% of patients were on none. Of the 61.4% of patients treated with restenting, 71.1% of them received a drug-eluting stent. Procedural success was 88.1%, and in-hospital death, stroke, and CABG occurred in 5.5%, 0.6%, and 6.1% of subjects, respectively. All-cause mortality at 1 year was 14.3%. Although female gender, diabetes mellitus (DM), bifurcation disease, ejection fraction <40%, and cardiogenic shock at the time of presentation were associated with an increased risk of in-hospital mortality, only DM (P = 0.047) and bifurcation disease (P = 0.027) remained independent predictors of in-hospital death. Conclusion: In-hospital mortality from definite ST is lower than previously reported, but long-term mortality remains high. DM and bifurcation disease, but not type of percutaneous therapy, are independently associated with in-hospital mortality.

Original languageEnglish (US)
Pages (from-to)550-556
Number of pages7
JournalCatheterization and Cardiovascular Interventions
Volume79
Issue number4
DOIs
StatePublished - Mar 1 2012

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Coronary Thrombosis
Stents
Registries
Thrombosis
Hospital Mortality
Diabetes Mellitus
Drug-Eluting Stents
Cardiogenic Shock
Mortality
Stroke
Survival
Therapeutics

Keywords

  • coronary intervention
  • stent
  • thrombosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

Contemporary clinical characteristics, treatment, and outcomes of angiographically confirmed coronary stent thrombosis : Results from a multicenter California registry. / Yeo, Khung Keong; Mahmud, Ehtisham; Armstrong, Ehrin J.; Bennett, William E.; Shunk, Kendrick A.; MacGregor, John S.; Li, Zhongmin; Low, Reginald; Rogers, Jason H.

In: Catheterization and Cardiovascular Interventions, Vol. 79, No. 4, 01.03.2012, p. 550-556.

Research output: Contribution to journalArticle

Yeo, Khung Keong ; Mahmud, Ehtisham ; Armstrong, Ehrin J. ; Bennett, William E. ; Shunk, Kendrick A. ; MacGregor, John S. ; Li, Zhongmin ; Low, Reginald ; Rogers, Jason H. / Contemporary clinical characteristics, treatment, and outcomes of angiographically confirmed coronary stent thrombosis : Results from a multicenter California registry. In: Catheterization and Cardiovascular Interventions. 2012 ; Vol. 79, No. 4. pp. 550-556.
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abstract = "Objectives: To describe the contemporary treatment and outcomes for patients with angiographically confirmed (definite) stent thrombosis (ST). Background: Limited data are available on contemporary treatment patterns and outcomes of patients with ST in the United States. Methods: In this multicenter California registry, consecutive cases of definite ST over 5 years were identified. Clinical characteristics, in-hospital outcomes, and long-term survival are reported. Results: One hundred and sixty five consecutive episodes of ST were identified in 153 patients from January 2005 to February 2010. The distribution of acute (≤24 hr), subacute (24 hr to 30 days), late (30 days to 1 year), and very late ({\^a}yen1 year) ST was 3.9{\%}, 21.8{\%}, 17.6{\%}, and 50.3{\%}, respectively. Only 41.2{\%} of patients were on dual antiplatelet therapy at the time of presentation, while 22.4{\%} of patients were on none. Of the 61.4{\%} of patients treated with restenting, 71.1{\%} of them received a drug-eluting stent. Procedural success was 88.1{\%}, and in-hospital death, stroke, and CABG occurred in 5.5{\%}, 0.6{\%}, and 6.1{\%} of subjects, respectively. All-cause mortality at 1 year was 14.3{\%}. Although female gender, diabetes mellitus (DM), bifurcation disease, ejection fraction <40{\%}, and cardiogenic shock at the time of presentation were associated with an increased risk of in-hospital mortality, only DM (P = 0.047) and bifurcation disease (P = 0.027) remained independent predictors of in-hospital death. Conclusion: In-hospital mortality from definite ST is lower than previously reported, but long-term mortality remains high. DM and bifurcation disease, but not type of percutaneous therapy, are independently associated with in-hospital mortality.",
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T1 - Contemporary clinical characteristics, treatment, and outcomes of angiographically confirmed coronary stent thrombosis

T2 - Results from a multicenter California registry

AU - Yeo, Khung Keong

AU - Mahmud, Ehtisham

AU - Armstrong, Ehrin J.

AU - Bennett, William E.

AU - Shunk, Kendrick A.

AU - MacGregor, John S.

AU - Li, Zhongmin

AU - Low, Reginald

AU - Rogers, Jason H

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N2 - Objectives: To describe the contemporary treatment and outcomes for patients with angiographically confirmed (definite) stent thrombosis (ST). Background: Limited data are available on contemporary treatment patterns and outcomes of patients with ST in the United States. Methods: In this multicenter California registry, consecutive cases of definite ST over 5 years were identified. Clinical characteristics, in-hospital outcomes, and long-term survival are reported. Results: One hundred and sixty five consecutive episodes of ST were identified in 153 patients from January 2005 to February 2010. The distribution of acute (≤24 hr), subacute (24 hr to 30 days), late (30 days to 1 year), and very late (âyen1 year) ST was 3.9%, 21.8%, 17.6%, and 50.3%, respectively. Only 41.2% of patients were on dual antiplatelet therapy at the time of presentation, while 22.4% of patients were on none. Of the 61.4% of patients treated with restenting, 71.1% of them received a drug-eluting stent. Procedural success was 88.1%, and in-hospital death, stroke, and CABG occurred in 5.5%, 0.6%, and 6.1% of subjects, respectively. All-cause mortality at 1 year was 14.3%. Although female gender, diabetes mellitus (DM), bifurcation disease, ejection fraction <40%, and cardiogenic shock at the time of presentation were associated with an increased risk of in-hospital mortality, only DM (P = 0.047) and bifurcation disease (P = 0.027) remained independent predictors of in-hospital death. Conclusion: In-hospital mortality from definite ST is lower than previously reported, but long-term mortality remains high. DM and bifurcation disease, but not type of percutaneous therapy, are independently associated with in-hospital mortality.

AB - Objectives: To describe the contemporary treatment and outcomes for patients with angiographically confirmed (definite) stent thrombosis (ST). Background: Limited data are available on contemporary treatment patterns and outcomes of patients with ST in the United States. Methods: In this multicenter California registry, consecutive cases of definite ST over 5 years were identified. Clinical characteristics, in-hospital outcomes, and long-term survival are reported. Results: One hundred and sixty five consecutive episodes of ST were identified in 153 patients from January 2005 to February 2010. The distribution of acute (≤24 hr), subacute (24 hr to 30 days), late (30 days to 1 year), and very late (âyen1 year) ST was 3.9%, 21.8%, 17.6%, and 50.3%, respectively. Only 41.2% of patients were on dual antiplatelet therapy at the time of presentation, while 22.4% of patients were on none. Of the 61.4% of patients treated with restenting, 71.1% of them received a drug-eluting stent. Procedural success was 88.1%, and in-hospital death, stroke, and CABG occurred in 5.5%, 0.6%, and 6.1% of subjects, respectively. All-cause mortality at 1 year was 14.3%. Although female gender, diabetes mellitus (DM), bifurcation disease, ejection fraction <40%, and cardiogenic shock at the time of presentation were associated with an increased risk of in-hospital mortality, only DM (P = 0.047) and bifurcation disease (P = 0.027) remained independent predictors of in-hospital death. Conclusion: In-hospital mortality from definite ST is lower than previously reported, but long-term mortality remains high. DM and bifurcation disease, but not type of percutaneous therapy, are independently associated with in-hospital mortality.

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