Acute infection-inflammation and coronary stent thrombosis: an observational study.

Autor: Del Pace S, Boddi M, Rasoini R, Micheli S, Alderighi C, Caciolli S, Margheri M, Abbate R, Gensini GF, Del Pace, Stefano, Boddi, Maria, Rasoini, Raffaele, Micheli, Serena, Alderighi, Camilla, Caciolli, Sabina, Margheri, Massimo, Abbate, Rosanna, Gensini, Gian Franco
Zdroj: Internal & Emergency Medicine; Apr2010, Vol. 5 Issue 2, p121-126, 6p
Abstrakt: Coronary stent thrombosis (CST) is a major concern of interventional cardiology. Several risk factors for CST have been identified, but as a whole they do not explain the pathophysiology of CST. This study was designed to investigate whether acute infection-inflammation could facilitate the occurrence of CST. Forty-one patients, aged 66.6 +/- 11 years, consecutively admitted to our catheterization laboratory for acute, subacute or late CST, were retrospectively analysed. Transient acute infection-inflammation on admission for CST was diagnosed by predefined criteria. Prevalence of known risk factors for CST was also investigated. Twenty-one patients (51%) met predefined criteria for the occurrence of acute infection-inflammation. On admission, in these patients, levels of systemic humoral and cellular inflammatory markers were significantly higher than those of patients without recent or ongoing acute infection-inflammation (p < 0.05 for all). 62% of patients with acute infection-inflammation had less than two known risk factors for CST whereas only 37% patients without infection-inflammation showed less than two risk factors (p = 0.03) and showed more frequent interruption of antiplatelet treatment (17 vs. 2.4%, p = 0.02), mean longer stent length (20.5 +/- 4.8 vs. 16.5 +/- 5.1 mm, p = 0.02) and lower left ventricular ejection fraction before CST (42.9 +/- 14 vs. 47.3 +/- 11%, p = 0.02). In conclusion, acute infection-inflammation could play a role in facilitating the occurrence of CST in a subgroup with low risk profile for known risk factors. Our findings, if confirmed, could suggest new opportunities for prevention and treatment of CST. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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