Incidence and predictors of coronary stent thrombosis: Evidence from an international collaborative meta-analysis including 30 studies, 221,066 patients, and 4276 thromboses

Autor: Gabriel Sardi, Gilles Lemesle, José M. de la Torre Hernández, Giuseppe Sangiorgi, Imad Sheiban, Philip Urban, Bo Lagerqvist, Fabrizio D'Ascenzo, Anetta Undas, John M. Lasala, Robert J. Applegate, Stefanie Schulz, Giuseppe Biondi-Zoccai, Mario Bollati, Antonio Colombo, Ron Waksman, Fabrizio Clementi, Ajay J. Kirtane, Maria Grazia Modena, Davide Castagno, Gregg W. Stone, Flavio Airoldi, Lisette Okkels Jensen, Piergiovanni Buonamici, Fiorenzo Gaita, Bruce R. Brodie, Juriën M. ten Berg, Giacomo Frati
Jazyk: angličtina
Rok vydání: 2013
Předmět:
Acute coronary syndrome
medicine.medical_specialty
Internationality
medicine.medical_treatment
Settore MED/11 - Malattie dell'Apparato Cardiovascolare
Coronary artery disease
Drug eluting stents
Meta-analysis
Stents
Stent thrombosis
Systematic review
drug-eluting stent
meta-analysis
coronary artery disease
stent
stent thrombosis
thrombosis
coronary stent
systematic review
Predictive Value of Tests
Internal medicine
Coronary stent
STENT THROMBOSIS
medicine
Humans
cardiovascular diseases
Cooperative Behavior
business.industry
Incidence
Coronary Thrombosis
CORONARY DISEASE
Percutaneous coronary intervention
Stent
Drug-Eluting Stents
equipment and supplies
medicine.disease
Thrombosis
Discontinuation
surgical procedures
operative
Platelet Aggregation Inhibitors
Withholding Treatment
Drug-eluting stent
Cardiology
Cardiology and Cardiovascular Medicine
business
Zdroj: D'Ascenzo, F, Bollati, M, Clementi, F, Castagno, D, Lagerqvist, B, de la Torre Hernandez, J M, Ten Berg, J M, Brodie, B R, Urban, P, Jensen, L O, Sardi, G, Waksman, R, Lasala, J M, Schulz, S, Stone, G W, Airoldi, F, Colombo, A, Lemesle, G, Applegate, R J, Buonamici, P, Kirtane, A J, Undas, A, Sheiban, I, Gaita, F, Sangiorgi, G, Modena, M G, Frati, G & Biondi-Zoccai, G 2013, ' Incidence and predictors of coronary stent thrombosis : Evidence from an international collaborative meta-analysis including 30 studies, 221,066 patients, and 4276 thromboses ', International Journal of Cardiology, vol. 167, no. 2, pp. 575-84 . https://doi.org/10.1016/j.ijcard.2012.01.080
DOI: 10.1016/j.ijcard.2012.01.080
Popis: Background Stent thrombosis remains among the most feared complications of percutaneous coronary intervention (PCI) with stenting. However, data on its incidence and predictors are sparse and conflicting. We thus aimed to perform a collaborative systematic review on incidence and predictors of stent thrombosis. Methods PubMed was systematically searched for eligible studies from the drug-eluting stent (DES) era (1/2002–12/2010). Studies were selected if including ≥2000 patients undergoing stenting or reporting on ≥25 thromboses. Study features, patient characteristics, and incidence of stent thrombosis were abstracted and pooled, when appropriate, with random-effect methods (point estimate [95% confidence intervals]), and consistency of predictors was formally appraised. Results A total of 30 studies were identified (221,066 patients, 4276 thromboses), with DES used in 87%. After a median of 22months, definite, probable, or possible stent thrombosis had occurred in 2.4% (2.0%; 2.9%), with acute in 0.4% (0.2%; 0.6%), subacute in 1.1% (1.0%; 1.3%), late in 0.5% (0.4%; 0.6%), and very late in 0.6% (0.4%; 0.8%). Similar figures were computed for studies reporting only on DES. From a total of 47 candidate variables, definite/probable stent thrombosis was more commonly and consistently predicted by early antiplatelet therapy discontinuation, extent of coronary disease, and stent number/length, with acute coronary syndrome at admission, diabetes, smoking status, and bifurcation/ostial disease also proving frequent predictors, but less consistently. Conclusions Despite numerous possible risk factors, the most common and consistent predictors of stent thrombosis are early antiplatelet therapy discontinuation, extent of coronary disease, and stent number/length.
Databáze: OpenAIRE
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