Stent thrombosis occurs infrequently after drug-eluting stent (DES) placement, but
concerns have surfaced that identification of stent thrombosis based solely on angiography
may underestimate the true incidence of this complication. The purpose of this study
was to compare rates of stent thrombosis using Academic Research Consortium (ARC)
definitions. From April 2002 to February 2005, bare-metal stents (BMSs) and DESs were
placed at Wake Forest University Baptist Medical Center. Rates of ARC definite, probable,
and possible stent thrombosis were evaluated. Overall, definite stent thrombosis occurred
in 1.4% of BMSs and 1.1% of DESs (p = 0.47); probable stent thrombosis, in 1.0% of
BMSs and 0.9% of DESs (p = 0.81); definite plus probable stent thrombosis, in 2.3%
of BMSs and 1.9% of DESs (p = 0.48); and possible stent thrombosis, in 6.8% of BMSs
and 3.5% of DESs (p <0.001). Rates of definite late (31 days to 1 year) and very late
(>1 year) stent thrombosis were 0.9% for BMSs and 0.06% for DESs (p <0.001) and 0.16%
for BMSs and 0.56% for DESs, respectively (p = 0.13). Rates of definite plus probable
and late and very late stent thrombosis were 1.1% for BMSs and 0.19% for DESs (p <0.001)
and 0.40% for BMSs and 0.68% for DESs, respectively (p = 0.31). Rates of possible
stent thrombosis increased significantly for each thrombosis interval. In conclusion,
rates of stent thrombosis using the proposed ARC definition differed by stent type,
definition of stent thrombosis, and thrombosis interval. Use of the ARC probable stent
thrombosis paralleled rates of definite stent thrombosis alone, but partially masked
the occurrence of late (>1 year) stent thrombosis in DESs compared with BMSs.
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Article info
Publication history
Published online: July 11, 2008
Accepted:
April 23,
2008
Received in revised form:
April 23,
2008
Received:
December 7,
2007
Identification
Copyright
© 2008 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
