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

Iqbal, Javaid; Sumaya, Wael; Tatman, Victoria; Parviz, Yasir; Morton, Allison; Grech, Ever; Campbell, Stephen; Storey, Robert F.; Gunn, Julian

doi:10.4244/eijv9i1a10

Cited by 73 publications

(50 citation statements)

References 35 publications

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“…Also, the implantation of ≥ 2 stents may be needed for the treatment of multiple lesions within IRA. Importantly, in line with previous reports, implantation of ≥ 2 stents was associated with increased risk of stent thrombosis [6,8]. A higher number of implanted stents/longer total stent length itself poses a risk of thrombotic complications after stent implantation.…”

Section: Discussionsupporting

confidence: 77%

“…In our study, multiple stent implantation was required in older patients with multi-vessel disease, as well as haemodynamically unstable patients. Importantly, haemodynamic instability (cardiogenic shock) itself is associated with increased risk of stent thrombosis [6,8]. However, the difference in the risk for stent thrombosis between patients treated with 1 stent vs. ≥ 2 stents persisted even after correction for potential confounding factors and risk profile.…”

Section: Discussionmentioning

confidence: 99%

“…Introduction of drug-eluting stents (DES) has contributed substantially to the reduction of the risk for TVR as compared to the use of bare-metal stents (BMS) [3,4]. Although even using new-generation DES, primary PCI with stent implantation in patients with acute coronary syndromes (ACS) carries an increased risk of stent thrombosis [3][4][5][6][7][8]. Observed risk of stent thrombosis is higher in patients requiring more complex revascularisation (longer stents, multiple stents) [6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

“…Observed risk of stent thrombosis is higher in patients requiring more complex revascularisation (longer stents, multiple stents) [6][7][8][9]. Confirmation of the impact of the number of stents implanted/total stent length on clinical outcomes (especially stent thrombosis) was drawn from large-scale registries including patients undergoing stent implantation for both ACS and non-ACS [6][7][8]. Previous studies have not addressed this issue specifically for patients undergoing primary PCI for STEMI.…”

Section: Introductionmentioning

confidence: 99%

“…Although even using new-generation DES, primary PCI with stent implantation in patients with acute coronary syndromes (ACS) carries an increased risk of stent thrombosis [3][4][5][6][7][8]. Observed risk of stent thrombosis is higher in patients requiring more complex revascularisation (longer stents, multiple stents) [6][7][8][9]. Confirmation of the impact of the number of stents implanted/total stent length on clinical outcomes (especially stent thrombosis) was drawn from large-scale registries including patients undergoing stent implantation for both ACS and non-ACS [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

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The impact of multiple stent implantation in the infarct-related artery on one-year clinical outcomes of patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention. Data from the Polish NRDES Registry

et al. 2016

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A b s t r a c t Background and aim:We sought to evaluate the impact of multiple stent implantation in the infarct-related artery (IRA) on one-year clinical outcomes of patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). Methods and results:Data on 1741 consecutive patients with STEMI, who underwent immediate PCI with implantation of ≥ 1 stent, enrolled the National Registry of Drug Eluting Stents (NRDES) were assessed. Patients were stratified based on the number of implanted stents in IRA: 1 vs. ≥ 2 stents. At the discretion of operators, ≥ 2 stents in IRA were implanted in 247 (14.2%) patients. The remaining 1494 patients were treated with a single stent. Patients treated with multiple stents were less likely to achieve Thrombolysis In Myocardial Infarction (TIMI) grade 3 flow after primary PCI. Overall mortality at one year was 8.3% in the single stent group and 10.3% in the ≥ 2 stents group (p = 0.37; adjusted for propensity score p = 0.13). After propensity score matching, patients treated with ≥ 2 stents were at higher risk of definite or probable stent thrombosis and urgent revascularisation at one year. Conclusions:In patients with STEMI undergoing primary PCI, a need for implantation of ≥ 2 stents in IRA carries an increased risk of stent thrombosis and urgent revascularisation at one year.

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Section: Discussionsupporting

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

The impact of multiple stent implantation in the infarct-related artery on one-year clinical outcomes of patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention. Data from the Polish NRDES Registry

et al. 2016

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Promising Technologies for STEMI Interventions

Loh¹,

Tan²

2017

Manual of STEMI Interventions

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Laser vaporization of atherothrombotic burden before drug‐coated balloon application in ST‐segment elevation myocardial infarction: Two‐year outcomes of the laser‐DCB trial

Tonomura

Shimada

Yamanaka

et al. 2022

Cathet Cardio Intervent

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Objectives This study aimed to examine whether the combination of excimer laser coronary atherectomy (ELCA) and drug‐coated balloon (DCB) angioplasty can provide feasible clinical outcome in patients with ST‐segment elevation myocardial infarction (STEMI) with 8‐month and 2‐year scheduled follow‐up angiography. Background Intracoronary thrombus elevates the risk of interventional treatment in patients with STEMI and hampers drug absorption into the vasculature released from DCB. Methods Sixty‐two patients with STEMI within 24 h after the onset of symptoms were enrolled in this prospective, single‐center, single‐arm study. Results The laser catheter was successfully crossed distal to the culprit lesion in all cases. No ELCA‐related adverse events occurred. Bail‐out stenting was required in two patients (3.2%) after adjunctive ballooning; thus, the remaining 60 patients were completed with DCB angioplasty without stenting. Scheduled angiography at 8 months and 2 years was completed in 100% and 85.2%, respectively, and minimal lumen diameters were 3.4 ± 0.5, 3.4 ± 0.6, and 3.4 ± 0.5 mm after the procedure, at 8 months and at 2 years, respectively. Binary restenosis was observed in five patients (8.1%) in whom target lesion revascularization was performed. The duration of dual antiplatelet therapy was 2.3 ± 2.2 months, and neither abrupt vessel closure, reinfarction, cardiac death nor major bleeding was observed. Conclusion A combination of DCB angioplasty with ELCA is a feasible therapeutic option for STEMI.

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

Abstract: 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.

Cited by 73 publications

References 35 publications

The impact of multiple stent implantation in the infarct-related artery on one-year clinical outcomes of patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention. Data from the Polish NRDES Registry

The impact of multiple stent implantation in the infarct-related artery on one-year clinical outcomes of patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention. Data from the Polish NRDES Registry

Promising Technologies for STEMI Interventions

Laser vaporization of atherothrombotic burden before drug‐coated balloon application in ST‐segment elevation myocardial infarction: Two‐year outcomes of the laser‐DCB trial

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