Clinical presentation of stent thrombosis (ST) and its sequela under contemporary
practice have not been fully elucidated largely due to rare incidence of ST. We sought
to assess the characteristics in patients with clinical presentation of ST and their
in-hospital outcomes, utilizing nationwide registration system for percutaneous coronary
interventions (J-PCI). The present study included acute coronary syndrome (ACS) patients
undergoing PCI with clinical findings of definite ST from January 2014 to December
2016. Patients’ characteristics, in-hospital mortality and its composite with periprocedural
complications were evaluated. Full match comparison was performed. During the study
period, 256,610 ACS patients (37.9% of total PCI cases) underwent PCI and 1,367 ST
patients (1.9%) were identified from 73,241 ACS patients’ records who had a history
of previous PCI. Overall, patients with ST were younger but had higher incidence of
previous myocardial infarction, compared with those without. In addition, ST patients
had increased rate of crude in-hospital death (4.8% vs 1.1%, p <0.001). After full
match comparison, the incidence of recurrent ST (post-PCI) was significantly higher
in ST patients when compared with ACS patients presenting without ST (4.3% vs 0.9%,
p <0.001). Despite younger age, patients with ST had significantly higher incidence
of in-hospital mortality and cardiovascular complications, including recurrent ST,
compared with those without.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to American Journal of CardiologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Improved safety and reduction in stent thrombosis associated with biodegradable polymer-based biolimus-eluting stents versus durable polymer-based sirolimus-eluting stents in patients with coronary artery disease: final 5-year report of the LEADERS (Limus Eluted From A Durable Versus ERodable Stent Coating) randomized, noninferiority trial.JACC Cardiovasc Interv. 2013; 6: 777-789
- Final 5-year follow-up of a randomized controlled trial of everolimus- and paclitaxel-eluting stents for coronary revascularization in daily practice: the COMPARE trial (A Trial of Everolimus-Eluting Stents and Paclitaxel Stents for Coronary Revascularization in Daily Practice).JACC Cardiovasc Interv. 2015; 8: 1157-1165
- Stent thrombosis with drug-eluting and bare-metal stents: evidence from a comprehensive network meta-analysis.Lancet. 2012; 379: 1393-1402
- Long-term safety of drug-eluting and bare-metal stents: evidence from a comprehensive network meta-analysis.J Am Coll Cardiol. 2015; 65: 2496-2507
- Prasugrel versus clopidogrel in patients with acute coronary syndromes.N Engl J Med. 2007; 357: 2001-2015
- Comparison of ticagrelor with clopidogrel in patients with a planned invasive strategy for acute coronary syndromes (PLATO): a randomised double-blind study.Lancet. 2010; 375: 283-293
- Biodegradable polymer biolimus-eluting stents versus durable polymer everolimus-eluting stents in patients with coronary artery disease: final 5-year report from the COMPARE II trial (Abluminal Biodegradable Polymer Biolimus-Eluting Stent Versus Durable Polymer Everolimus-Eluting Stent).JACC Cardiovasc Interv. 2017; 10: 1215-1221
- 10-year clinical outcome after randomization to treatment by sirolimus- or paclitaxel-eluting coronary stents.J Am Coll Cardiol. 2017; 69: 616-624
- Drug-eluting stent thrombosis: results from the multicenter Spanish registry ESTROFA (Estudio ESpanol sobre TROmbosis de stents FArmacoactivos).J Am Coll Cardiol. 2008; 51: 986-990
- Comparisons of baseline demographics, clinical presentation, and long-term outcome among patients with early, late, and very late stent thrombosis of sirolimus-eluting stents: observations from the Registry of Stent Thrombosis for Review and Reevaluation (RESTART).Circulation. 2010; 122: 52-61
- Lower risk of stent thrombosis and restenosis with unrestricted use of 'new-generation' drug-eluting stents: a report from the nationwide Swedish Coronary Angiography and Angioplasty Registry (SCAAR).Eur Heart J. 2012; 33: 606-613
- Incidence and determinants of complications in rotational atherectomy: insights from the national clinical data (J-PCI Registry).Circ Cardiovasc Interv. 2016; : 9
- Comparison of outcomes of women versus men with non-ST-elevation acute coronary syndromes undergoing percutaneous coronary intervention (from the Japanese Nationwide Registry).Am J Cardiol. 2017; 119: 826-831
- Relation of ST-segment elevation myocardial infarction to daily ambient temperature and air pollutant levels in a Japanese Nationwide Percutaneous Coronary Intervention Registry.Am J Cardiol. 2017; 119: 872-880
- Impact of institutional and operator volume on short-term outcomes of percutaneous coronary intervention: a report from the Japanese Nationwide Registry.JACC Cardiovasc Interv. 2017; 10: 918-927
- Clinical end points in coronary stent trials: a case for standardized definitions.Circulation. 2007; 115: 2344-2351
- Stent thrombosis in randomized clinical trials of drug-eluting stents.N Engl J Med. 2007; 356: 1020-1029
- Clinical presentation, management, and outcomes of angiographically documented early, late, and very late stent thrombosis.JACC Cardiovasc Interv. 2012; 5: 131-140
- Incidence, determinants and clinical impact of definite stent thrombosis on mortality in women: from the WIN-DES collaborative patient-level pooled analysis.Int J Cardiol. 2018; 263: 24-28
- Antiplatelet therapy and stent thrombosis after sirolimus-eluting stent implantation.Circulation. 2009; 119: 987-995
- ST-segment elevation myocardial infarction due to early and late stent thrombosis a new group of high-risk patients.J Am Coll Cardiol. 2008; 51: 2396-2402
- Stent thrombosis following bare-metal stent implantation: success of emergency percutaneous coronary intervention and predictors of adverse outcome.Eur Heart J. 2005; 26: 1180-1187
- Intravascular ultrasound findings during episodes of drug-eluting stent thrombosis.J Am Coll Cardiol. 2007; 50: 2095-2097
- Incomplete stent apposition and very late stent thrombosis after drug-eluting stent implantation.Circulation. 2007; 115: 2426-2434
Article info
Publication history
Published online: December 09, 2019
Received in revised form:
November 25,
2019
Received:
August 28,
2019
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.
