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23 April 2009

Life after coronary stent thrombosis

David BeckerABCDEF, Pal Maurovich-HorvatABCDEF, Gyorgy BarcziBDEF, Gyorgy SzaboBDE, Gabor FulopBDE, Andrea NagyBCDE, Levente MolnarBDE, Astrid AporBDE, Eva BeliczaBCDE, Bela MerkelyABCDEG

Med Sci Monit 2009; 15(5): CR236-241 :: ID: 869645

Abstract

Background
Coronary stent thrombosis is a catastrophic complication of percutaneous coronary intervention. There is a paucity of long-term data regarding the clinical outcome of patients who have suffered stent thrombosis.
Material and Method
We sought to assess the long-term clinical outcome of patients who suffered de novo ST-segment elevation myocardial infarction as well as those who suffered ST-segment elevation myocardial infarction as a result of stent thrombosis. In both patient groups, major cardiac adverse events were studied during a 1-year follow-up period.
Results
A total of 1890 consecutive patients who presented with ST-segment elevation myocardial infarction during the period January 2003 to December 2005 were studied: 1843 (97.5%) suffered de novo ST-segment elevation myocardial infarction, and 47 (2.5%) suffered ST-segment elevation myocardial infarction as a consequence of stent thrombosis. The rate of cardiogenic shock was significantly higher in the stent thrombosis group than in the de novo thrombosis group (21.3% vs 4.8%, respectively) (P<0.001). Mortality rates at 30 days (6.4% vs 8.8%) and at 1 year (17.0% vs 14.9%) showed no significant difference between the 2 groups. The repeat revascularization rate was higher among patients with post-stent thrombosis (35.7% vs 9.1%) (P<0.001), as was the major cardiovascular event rate (57.1% vs 31.2%) (P<0.001).
Conclusions
The long-term clinical outcome of patients who have suffered stent thrombosis is poor. Additional research is warranted to further improve therapeutic measures associated with stent thrombosis.

Keywords: Stents, Prospective Studies, Myocardial Infarction - surgery, Follow-Up Studies, Coronary Vessels - pathology, Aged, 80 and over, Thrombosis - pathology

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750