Observations and Outcomes of Definite and Probable Drug-Eluting Stent Thrombosis Seen at a Single Hospital in a Four-Year Period

Tina L. Pinto Slottow, Daniel H. Steinberg, Probal K. Roy, Ashesh N. Buch, Teruo Okabe, Zhenyi Xue, Kimberly Kaneshige, Rebecca Torguson, Joseph Lindsay, Augusto D. Pichard, Lowell F. Satler, William O. Suddath, Kenneth M. Kent, Ron Waksman*

*Corresponding author for this work

    Research output: Contribution to journalArticlepeer-review

    50 Citations (Scopus)

    Abstract

    Stent thrombosis (ST) is a major safety concern after drug-eluting stent (DES) deployment, resulting in significant morbidity and mortality. The goal of this study was to examine the incidence, timing, clinical correlates, and outcomes after DES thrombosis in a real-world population. A retrospective analysis of 8,402 patients who underwent percutaneous coronary intervention and received a DES was performed. After DES implantation, 84 definite (DST) and 127 probable ST events occurred. The incidence of early DST was 0.8%, late DST was 0.4%, and very late DST was 0.4%. Multivariate analysis showed that a history of diabetes mellitus, myocardial infarction during admission, number of stents, and DES placement in a restenotic lesion were independently associated with DST. The incidence of early definite or probable ST (DPST) was 1.9%, late DPST was 1.4%, and very late DPST was 0.7%. Multivariate analysis showed that a history of diabetes, myocardial infarction during admission, cardiogenic shock, number of stents, and DES use in a restenotic lesion were independently associated with DPST. Both types of ST were associated with significantly higher rates of all-cause death, Q-wave myocardial infarction, and revascularization up to 24 months after DES implantation. In conclusion, ST after DES implantation in contemporary practice continues to occur from 30 days to 2 years at a rate ≥0.36%/year and is associated with high rates of morbidity and mortality. Diabetes mellitus, myocardial infarction, and DES use in a restenotic lesion were strongly associated with DST; therefore, careful consideration should apply when deploying a DES in these populations.

    Original languageEnglish
    Pages (from-to)298-303
    Number of pages6
    JournalAmerican Journal of Cardiology
    Volume102
    Issue number3
    DOIs
    Publication statusPublished - 1 Aug 2008

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