Clinical presentation, management, and outcomes of angiographically documented early, late, and very late stent thrombosis.

Published

Journal Article

OBJECTIVES: The aim of this study was to describe differences in treatment and in-hospital mortality of early, late, and very late stent thrombosis (ST). BACKGROUND: Early, late, and very late ST may differ in clinical presentation, management, and in-hospital outcomes. METHODS: We analyzed definite (angiographically documented) ST cases identified from February 2009 to June 2010 in the CathPCI Registry. We stratified events by timing of presentation: early (≤1 month), late (1 to 12 months), or very late (≥12 months) following stent implantation. Multivariable logistic regression modeling was performed to compare in-hospital mortality for each type of ST after adjusting for baseline comorbidities. RESULTS: During the study period, 7,315 ST events were identified in 7,079 of 401,662 patients (1.8%) presenting with acute coronary syndromes. This ST cohort consisted of 1,391 patients with early ST (19.6%), 1,370 with late ST (19.4%), and 4,318 with very late ST (61.0%). Subjects with early ST had a higher prevalence of black race and diabetes, whereas subjects with very late ST had a higher prevalence of white race and a lower prevalence of prior myocardial infarction or diabetes. In-hospital mortality was significantly higher in early ST (7.9%) compared with late (3.8%) and very late ST (3.6%, p<0.001). This lower mortality for late and very late ST persisted after multivariable adjustment (odds ratio: 0.53 [95% confidence interval (CI): 0.36 to 0.79] and 0.58 [95% CI: 0.43 to 0.79], respectively). CONCLUSIONS: Significant differences exist in the presentation and outcomes of early, late, and very late ST. Among patients with acute coronary syndromes who are undergoing percutaneous coronary intervention for angiographically documented ST, early ST is associated with the highest in-hospital mortality.

Full Text

Duke Authors

Cited Authors

  • Armstrong, EJ; Feldman, DN; Wang, TY; Kaltenbach, LA; Yeo, K-K; Wong, SC; Spertus, J; Shaw, RE; Minutello, RM; Moussa, I; Ho, KKL; Rogers, JH; Shunk, KA

Published Date

  • February 2012

Published In

Volume / Issue

  • 5 / 2

Start / End Page

  • 131 - 140

PubMed ID

  • 22361596

Pubmed Central ID

  • 22361596

Electronic International Standard Serial Number (EISSN)

  • 1876-7605

International Standard Serial Number (ISSN)

  • 1936-8798

Digital Object Identifier (DOI)

  • 10.1016/j.jcin.2011.10.013

Language

  • eng