Predictors of Sub-Acute Stent Thrombosis in Acute Myocardial Infarction Patients Following Primary Coronary Stenting With Bare Metal Stent

Katayama, Toshiro; Nakashima, Hiroshi; Takagi, Chisa; Honda, Yukiharu; Suzuki, Shin; Iwasaki, Yoshihiro; Yamamoto, Tadashi; Yoshioka, Masato; Yano, Katsusuke

doi:10.1253/circj.70.151

Cited by 15 publications

(8 citation statements)

References 31 publications

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“…In patients with acute coronary syndrome, the reported incidence of subacute ST after elective stenting ranges from 0.4% to 3.2% [5][6][7][8][9] and can be up to 6%. 4,10,15 Consistent with the results from these trials, the overall incidence of early ST was 4.5%. There are also reports suggesting that the incidence of ST is significantly higher for primary coronary stenting than for elective stenting 9,11 because of the delayed inhibition of platelet aggregation by unplanned antiplatelet therapy for the marked increase in platelet reactivity in AMI.…”

Section: Discussionsupporting

confidence: 75%

Early Stent Thrombosis in Patients Undergoing Primary Coronary Stenting for Acute Myocardial Infarction: Incidence, a Simple Risk Score, and Prognosis

Ergelen

Uyarel

Osmonov

et al. 2009

Clin Appl Thromb Hemost

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Section: Discussionsupporting

confidence: 75%

Early Stent Thrombosis in Patients Undergoing Primary Coronary Stenting for Acute Myocardial Infarction: Incidence, a Simple Risk Score, and Prognosis

Ergelen

Uyarel

Osmonov

et al. 2009

Clin Appl Thromb Hemost

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“…Second, in patients with AMI, the inflammatory process of coronary plaque vulnerability may be associated with CRP concentration. Recently, Katayama et al 29 reported a relationship between inflammation and subacute thrombosis (SAT) in patients with AMI treated with primary coronary stenting. The peak CK concentration and EF did not differ between patients with and without SAT; however, the inflammatory markers, peak CRP and amyloid-A protein concentrations were higher in patients with SAT.…”

Section: Discussionmentioning

confidence: 99%

Peak C-Reactive Protein Concentration Correlates With Left Ventricular Thrombus Formation Diagnosed by Contrast Echocardiographic Left Ventricular Opacification in Patients With a First Anterior Acute Myocardial Infarction

Seo

Maeda

Ishizu

et al. 2006

Circ J

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eft ventricular (LV) thrombus formation is a complication of acute myocardial infarction (AMI) and it is more prevalent in patients with an anterior AMI, because of the extensive area of severe apical wall motion abnormality with stagnant flow. [1][2][3] Before the era of early revascularization (ie, intravenous thrombolysis or primary coronary intervention), LV thrombus developed in 39% of patients with a first anterior AMI. 4 Although recent studies report that the prevalence has decreased because of early revascularization, 5-9 LV thrombus formation is still a risk of arterial embolism in patients with anterior wall AMI. 6,10 Apical contraction abnormalities with stagnant flow are important factors related to LV thrombus formation, but that alone is not sufficient to identify high-risk patients. Therefore, identification of additional risk factors may be useful. Recently, LV diastolic dysfunction and inflammatory reactions have been reported as associated with LV thrombus formation, 11-13 although reliable predictors have not yet been determined.LV thrombus can be diagnosed with transthoracic echocardiography, 14,15 although on occasion, either the vague nature of the thrombus or technical limitations in the examination renders confirmation difficult. 16 Contrast echocardiography is a useful modality for detecting LV thrombus, because the LV opacification can improve endocardial border delineation in the LV apex. [17][18][19][20] In addition, contrast echocardiography can visualize intraventricular flow dynamics, and recently our group reported that it is possible to determine the presence of stagnant flow with this technique. 21 However, systematic and prospective studies of contrast echocardiographic diagnosis of LV thrombus in patients with first anterior AMI have not been performed. Therefore, the purpose of this study was to prospectively study the determinants of LV thrombus using contrast echocardiography in patients with their first anterior AMI. Methods Study PopulationThis Background Wall motion abnormality in the apical legion of the left ventricle (LV) with stagnant flow alone is not sufficient to identify patients at high risk for LV thrombus formation among those with first anterior acute myocardial infarction (AMI). The aim of this study was to identify the determinants of LV thrombus formation using contrast echocardiography. Methods and ResultsIn 75 patients with first anterior AMI, standard and contrast echocardiography was performed to detect LV thrombus. Although LV thrombus was found in 10 patients (13%) using standard echocardiography, it was found in 15 patients (20%) using contrast echocardiography. Apical stagnant flow was observed in 14 patients (93%) with LV thrombus. In addition, patients with LV thrombus had a higher peak C-reactive protein (CRP) concentration (18.2±4.3 vs 7.9±5.5 mg/dl, p<0.0001). In multivariate analysis, only peak CRP concentration was identified as an independent predictor of LV thrombus (p=0.02, odds ratio: 1.400, confidence interval: 1.040-1.884). The receiv...

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“…We have reported that in patients with AMI treated with primary coronary stenting, inflammation may be closely related to stent thrombosis. 26) Inflammation may play an important role in aggregation processes in this case, because the CRP value on admission of this case was also high. Conclusion: To the best of our knowledge, the most delayed case of BMS thrombosis is 5 years after stent implantation.…”

Section: Discussionmentioning

confidence: 78%

<b>A Case Report of Very Late Thrombosis of Coronary Bare-Metal Stent 10 Years After Stenting</b>

Katayama¹,

Yamamoto²,

Iwasaki³

2007

Int. Heart J.

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SUMMARYAlthough late stent thrombosis is not uncommon with the use of drug-eluting stents, it is unusual with the use of bare-metal stents (BMS) because stent endothelialization is considered to be completed 4 weeks after the intervention. 1)A 64 year-old male had undergone percutaneous coronary intervention (PCI) for a proximal left anterior descending (LAD) artery lesion with a BMS and excellent angiographic results were obtained. Two hundred mg of ticlopidine was prescribed for one month and 100 mg of aspirin daily was continued. One year after stent implantation, coronary angiography (CAG) showed no restenosis. Ten years and 7 months after stent implantation, he suffered an acute myocardial infarction due to stent thrombosis. Intracoronary aspiration thrombectomy was successful. To the best of our knowledge, the longest delayed case of BMS thrombosis is 5 years after stent implantation.2) Our report demonstrated evidence of the latest reported case of stent thrombosis with the use of a BMS. (Int Heart J 2007; 48: 547-552)

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Predictors of Sub-Acute Stent Thrombosis in Acute Myocardial Infarction Patients Following Primary Coronary Stenting With Bare Metal Stent

Cited by 15 publications

References 31 publications

Early Stent Thrombosis in Patients Undergoing Primary Coronary Stenting for Acute Myocardial Infarction: Incidence, a Simple Risk Score, and Prognosis

Early Stent Thrombosis in Patients Undergoing Primary Coronary Stenting for Acute Myocardial Infarction: Incidence, a Simple Risk Score, and Prognosis

Peak C-Reactive Protein Concentration Correlates With Left Ventricular Thrombus Formation Diagnosed by Contrast Echocardiographic Left Ventricular Opacification in Patients With a First Anterior Acute Myocardial Infarction

<b>A Case Report of Very Late Thrombosis of Coronary Bare-Metal Stent 10 Years After Stenting</b>

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