TY - JOUR
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
PY - 2012/3/1
Y1 - 2012/3/1
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.
KW - coronary intervention
KW - stent
KW - thrombosis
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U2 - 10.1002/ccd.23011
DO - 10.1002/ccd.23011
M3 - Article
C2 - 21563289
AN - SCOPUS:84857445958
VL - 79
SP - 550
EP - 556
JO - Catheterization and Cardiovascular Interventions
JF - Catheterization and Cardiovascular Interventions
SN - 1522-1946
IS - 4
ER -