Incidence and predictors of stent thrombosis: a single-centre study of 5,833 consecutive patients undergoing coronary artery stenting

EuroIntervention. 2013 May 20;9(1):62-9. doi: 10.4244/EIJV9I1A10.

Abstract

Aims: Stent thrombosis (ST) is an infrequent but potentially fatal complication of PCI. The reported incidence of ST varies from 0-5%, due to differences in definition of ST, inclusion/exclusion criteria, and the type of stent and dual antiplatelet therapy used. We aimed to examine the incidence of ST and associated risk factors in this "real-world, all-comers" study.

Methods and results: All patients undergoing PCI at South Yorkshire Cardiothoracic Centre (UK) between 2007 and 2010 were included, with no exclusion criteria. ST cases were divided into definite and probable ST, according to the ARC criteria. Univariate predictors were identified using Student's t-test and chi-square test, and entered into a Cox proportional hazards model to identify factors independently associated with ST. For 5,833 PCI patients followed up for two years, the incidence of definite and probable ST together was 1.9% (n=109); of these 73% were early, 11% late and 16% very late ST. Cardiogenic shock, ST-elevation myocardial infarction (STEMI), lack of dual antiplatelet treatment, diabetes mellitus, stent length and stent diameter were the independent predictors of ST.

Conclusions: The incidence of definite/probable ST in this "real-world" registry is 1.9%. Cardiogenic shock, often excluded in clinical trials, is the strongest independent predictor of ST.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Chi-Square Distribution
  • Coronary Artery Disease / epidemiology
  • Coronary Artery Disease / therapy*
  • Coronary Thrombosis / epidemiology*
  • Diabetes Mellitus / epidemiology
  • Drug Therapy, Combination
  • England / epidemiology
  • Female
  • Humans
  • Incidence
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Myocardial Infarction / epidemiology
  • Myocardial Infarction / therapy
  • Percutaneous Coronary Intervention / adverse effects*
  • Percutaneous Coronary Intervention / instrumentation*
  • Platelet Aggregation Inhibitors / therapeutic use
  • Proportional Hazards Models
  • Registries
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Shock, Cardiogenic / epidemiology
  • Shock, Cardiogenic / therapy
  • Stents*
  • Time Factors
  • Treatment Outcome

Substances

  • Platelet Aggregation Inhibitors