Incidence, predictors, and long term clinical outcome of angiographic definite stent thrombosis in real world scenario - A prospective cohort study

Autor: Naved Aslam, Bhupinder Singh, Abhishek Goyal, Gurpreet Singh Wander, Basvappa Ramesh, Shibba Takkar Chhabra, Bishav Mohan, Vivek Singla, Manjunath Cholenhally Nanjappa, Yadvinder Singh, Vikram B Kolhari, Ravindran Rajendran
Rok vydání: 2017
Předmět:
Bare-metal stent
Male
medicine.medical_specialty
Acute coronary syndrome
Time Factors
medicine.medical_treatment
Shock
Cardiogenic
India
030204 cardiovascular system & hematology
Coronary Angiography
03 medical and health sciences
0302 clinical medicine
Percutaneous Coronary Intervention
Predictive Value of Tests
Risk Factors
Internal medicine
medicine
Humans
cardiovascular diseases
030212 general & internal medicine
Myocardial infarction
Prospective Studies
Prospective cohort study
Aged
business.industry
Coronary Thrombosis
Incidence
Stent
Percutaneous coronary intervention
Drug-Eluting Stents
General Medicine
Middle Aged
medicine.disease
surgical procedures
operative
Treatment Outcome
Drug-eluting stent
Cardiology
ST Elevation Myocardial Infarction
Female
Stents
Cardiology and Cardiovascular Medicine
business
TIMI
Zdroj: Cardiovascular revascularization medicine : including molecular interventions. 19(6)
ISSN: 1878-0938
Popis: Background The occurrence of stent thrombosis (ST) in real world scenario is far different from that mentioned in the literature. Our study identifies the various parameters of ST. Methods This is a prospective observational-cohort study where-in consecutive patients who received successful percutaneous transluminal angioplasty (PTCA) over the study period of 1-year was included and were followed for 1-year from the primary procedure. Results The overall incidence of definite ST was 1.4% and 1.7% at 30 days and 1 year respectively. The most common mode of presentation of ST was ST-elevation myocardial infarction (82.6%). The history of prior PTCA, multi-vessel disease, emergent PTCA, acute coronary syndrome and type B2/C lesions were found to be the independent predictors for definite ST. The incidence of late ST was significantly higher with bare metal stent (BMS) than drug-eluting stent (DES) (OR-2.4, 95% CI:1.3–4.5). At mean follow-up of 13.9 months after ST, the overall mortality was 36.9%. The independent predictors of mortality after ST were post-PTCA thrombolysis in myocardial infarction (TIMI) flow grade cardiogenic shock at the time of presentation. Conclusion The overall incidence of definite ST is high in the real world scenario and the DES fared better than BMS. ST carries a bad prognosis especially so if the patients present in cardiogenic shock, or unable to achieve TIMI-3 flow after PTCA.
Databáze: OpenAIRE
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