Temporal patterns, characteristics, and predictors of clinical outcomes in patients undergoing percutaneous coronary intervention for stent thrombosis

Abstract

Background: There are limited data on the outcomes of PCI following stent thrombosis (ST) and differences exist based on timing.Aim: To study the rates and characteristics of patients with a ST indication for PCI and compare procedural outcomes based on ST timing.Methods: All PCI procedures in England and Wales (2014-2020) were retrospectively analysed, stratified by the presence of ST, into four groups: non-ST, early-ST:0-30 days, late-ST:>30-360 days, very late-ST:>360 days. Multivariable logistic regression models were performed to assess the odds ratios (OR) of in-hospital MACCE (major acute cardiovascular and cerebrovascular complications; composite of mortality, acute stroke and reinfarction) and mortality.Results: Overall, 7,923 (1.4%) procedures were for ST indication, most commonly for early-ST (n=4,171, 52.6%) followed by very late-ST (n=2,801, 35.4%) and late-ST (n=951, 12.0%).The rate of PCI for ST declined between 2014 and 2020 (1.7 to 1.4%, p<0.001). Early-ST was the only subgroup associated with increased odds of MACCE (1.22 95%CI 1.05-1.41), allcause mortality (1.21 95%CI 1.07-1.36) and reinfarction (2.48 95%CI 1.48-4.14), compared with non-ST indication. The odds of mortality were significantly reduced in ST patients with the use of intravascular imaging (0.66 95%CI 0.48-0.92) and newer P2Y12 inhibitors

Frequency of Early Stent Thrombosis (Acute and Subacute) in Patients Presenting With Acute St Elevation Myocardial Infarction (Stemi) Undergoing Primary Percutaneous Coronary Intervention (Pci)

“…These early occurrences are thought to be caused by various procedural variables and lesion-related characteristics, either separately or in combination, such as stent underexpansion, tissue protrusion, residual thrombus, edge dissection, and impaired flow. (8)(9)(10). 'In our study,' the incidence of early stent thrombosis ('ST'), comprising 'acute or sub-acute' occurrences after primary percutaneous coronary intervention ('PCI'), was 5.8%.…”

Outcome of Primary Percutaneous Coronary Intervention for STEMI due to Stent Thrombosis

“…This quasi-experimental study was conducted at Lady Reading Hospital, Peshawar, over a six-month period from July to December 2023, following the receipt of ethical approval from the institutional review board, in compliance with the Declaration of Helsinki principles for ethical research (13). The study cohort comprised 150 patients who were diagnosed with ST-elevation myocardial infarction (STEMI) attributable to stent thrombosis (ST) and subsequently underwent percutaneous coronary intervention (PCI).…”