Author + information
- Ricardo A. Costa,
- Amanda Sousa,
- Jose de Ribamar Costa,
- Adriana Moreira,
- Galo Maldonado,
- Manuel Cano,
- Cantídio Campos,
- Lucas Damiani,
- Richardo Pavanello and
- J. Eduardo Sousa
Stent thrombosis (ST) has been described as a rare event in the current percutaneous coronary intervention (PCI) era; however, its occurrence has been associated with increased morbimortality. Our purpose was to identify the predictors of ST in a large cohort of patients treated with drug-eluting stents (DES) in daily practice.
A total of 5,614 pts (9,045 lesions) undergoing elective for emergency PCI solely with DES (n=9,680) as a default strategy were enrolled between May/02-Aug/14. Clinical follow-up (FU) was performed at 1, 6 and 12 months and yearly up to 12 years (97%). ST was defined according to the propositions of the Academic Research Consortium.
Mean age was 64.6 years, 32% had diabetes, 21.4% had previous myocardial infarction (MI) (≥30 days), and 42% had acute coronary syndrome or recent MI (<30 days). Overall, the incidence of ST was 2.4% (n=133), given that 95% of patients were ST-free up to 12 years follow-up (Kaplan-Meier estimate). The predictors of early (<30 days), late (1 to 12 months) and very late ST (>12 months) are shown in the Table.
The occurrence of ST up to 12 years was relatively low (2.4%) and significantly associated with history of cardiovascular disease, diabetes, recent MI and total stent length at an early phase; prior PCI, recent MI, SVG, lesion complexity and stent type between 1 and 12 months; and prior PCI, recent MI and total stent length more than 12 months.
|Early ST||Odds Ratio||95% CI||p value|
|History of cardiovascular disease||6.15||1.37||20.09||0.01|
|Recent MI (<30 days)*||4.86||1.33||14.54||0.01|
|Total stent length||1.03||1.00||1.05||0.01|
|Late ST||Hazard Ratio||95% CI||p value|
|Recent MI (<30 days)**||2.62||1.57||4.38||<0,001|
|Lesion class type C (ACC/AHA)||1.75||1.04||2.94||0.04|
|Second generation DES||0.45||0.21||0.96||0.04|
|Very Late ST||Hazard Ratio||95% CI||p value|
|Recent MI (<30 days)*||2.38||1.12||5.05||0.02|
|Recent MI (<30 days)**||2.25||1.19||4.23||0.01|
|Total stent length||1.02||1.00||1.03||0.01|
Poster Hall B1
Saturday, March 14, 2015, 10:00 a.m.-10:45 a.m.
Session Title: Coronary I
Abstract Category: 32. TCT@ACC-i2: Complex Patients/Comorbidities
Presentation Number: 2100-293
- 2015 American College of Cardiology Foundation