Correlates and long-term outcomes of angiographically proven stent thrombosis with sirolimus- and paclitaxel-eluting stents
- Authors
- Kuchulakanti P.K.; Chu W.W.; Torguson R.; Ohlmann P.; Rha S.-W.; Clavijo L.C.; Kim S.-W.; Bui A.; Gevorkian N.; Xue Z.; Smith K.; Fournadjieva J.; Suddath W.O.; Satler L.F.; Pichard A.D.; Kent K.M.; Waksman R.
- Issue Date
- Feb-2006
- Publisher
- LIPPINCOTT WILLIAMS & WILKINS
- Keywords
- Angioplasty; Clopidogrel; Stents; Thrombosis
- Citation
- Circulation, v.113, no.8, pp 1108 - 1113
- Pages
- 6
- Indexed
- SCOPUS
- Journal Title
- Circulation
- Volume
- 113
- Number
- 8
- Start Page
- 1108
- End Page
- 1113
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/19329
- DOI
- 10.1161/CIRCULATIONAHA.105.600155
- ISSN
- 0009-7322
1524-4539
- Abstract
- Background - Stent thrombosis (ST) is a serious complication of drug-eluting stent (DES) implantation regardless of the timing (acute, subacute, or late). The correlates of ST with DES are not yet completely elucidated. Methods and Results - From a total cohort of 2974 consecutive patients treated with DES since April 2003, we identified 38 patients who presented with angiographic evidence of ST (1.27%). The ST occurred acutely in 5 patients, subacutely (s30 days) in 25 patients, and late (>30 days) in 8 patients. The clinical, angiographie, and procedural variables of these patients were compared with the remaining 2936 consecutive patients who underwent DES implantation and did not experience ST during a follow-up of 12 months. Logistic regression analysis was conducted to determine the correlates of ST. Compared with patients without ST, patients with ST had a higher frequency of diabetes, acute postprocedural renal failure, and chronic renal failure. There were more bifurcation lesions, type C lesions, and a trend for smaller-diameter stents. Discontinuation of clopidogrel was higher in these patients (36.8% versus 10.7%; P<0.0001). The mean duration to ST from the stent implantation was 8.9±8.5 days in subacute and 152.7±100.4 days in late thrombosis cases. Mortality was significantly higher in patients with ST compared with those without ST at 6 months (31% versus 3%; P<0.001). Multivariate analysis detected cessation of clopidogrel therapy, renal failure, bifurcation lesions, and in-stent restenosis as significant correlates of ST (P<0.05). Conclusions - ST continues to be a serious complication of contemporary DES use. Careful management is warranted in patients with renal failure and in those undergoing treatment for in-stent restenosis and bifurcations. Special focus on clopidogrel compliance may minimize the incidence of ST after DES implantation. © 2006 American Heart Association, Inc.
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Collections - 2. Clinical Science > Department of Cardiology > 1. Journal Articles
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