Document Detail

Angiographic predictors of recurrent stent thrombosis (from the Outcome of PCI for stent-ThrombosIs MultIcentre STudy [OPTIMIST]).
MedLine Citation:
PMID:  20538119     Owner:  NLM     Status:  MEDLINE    
Stent thrombosis is a catastrophic occurrence burdened by a high mortality rate and a tendency to recur. We sought to evaluate the angiographic risk factors for recurrent stent thrombosis (rST) in a subpopulation of 91 Outcome of PCI for stent-ThrombosIs Multicenter STudy (OPTIMIST) patients who underwent quantitative angiographic evaluation by an independent core laboratory. The Academic Research Consortium criteria were used for rST adjudication. A multivariate Cox proportional hazards model was applied to estimate the hazard ratios and the corresponding 95% confidence intervals for the occurrence of Academic Research Consortium-defined, definite rST (primary end point), definite or probable rST (secondary end point), and definite or probable or possible rST (secondary end point). A total of 8 definite rST events occurred during a median follow-up of 244 days (range 165 to 396), of which 5 were early and 3 were late. In the multivariate model, a residual thrombus score of > or =3 (hazard ratio 6.5, 95% confidence interval 1.4 to 30.7, p = 0.017) and a larger postprocedural reference vessel diameter (hazard ratio 4.5, 95% confidence interval 1.5 to 13.3, p = 0.006) were significantly associated with the primary end point. When the same model was applied to the 15 definite and probable rST events, only a residual thrombus score of > or =3 (hazard ratio 7.8, 95% confidence interval 2.5 to 24.5, p <0.001) was significantly associated with rST. Finally, when possible rST events were included (18 patients), a residual thrombus score of > or =3 remained associated with the dependent variable (hazard ratio 6.1, 95% confidence interval 2.0 to 18.2, p = 0.001), along with a larger postprocedural reference vessel diameter. In conclusion, when performing percutaneous coronary intervention for stent thrombosis, the residual thrombus burden and larger reference vessel were potent risk factors for rST.
Italo Porto; Francesco Burzotta; Antonio Parma; Christian Pristipino; Alessandro Manzoli; Flavia Belloni; Gennaro Sardella; Stefano Rigattieri; Alessandro Danesi; Pietro Mazzarotto; Francesco Summaria; Enrico Romagnoli; Francesco Prati; Carlo Trani; Filippo Crea
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial    
Journal Detail:
Title:  The American journal of cardiology     Volume:  105     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-06-11     Completed Date:  2010-07-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1710-5     Citation Subset:  AIM; IM    
Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy.
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MeSH Terms
Angioplasty, Transluminal, Percutaneous Coronary / methods*
Coronary Angiography*
Coronary Restenosis / epidemiology,  radiography*
Coronary Thrombosis / radiography*,  surgery
Follow-Up Studies
Italy / epidemiology
Middle Aged
Predictive Value of Tests
Prosthesis Failure
Survival Rate
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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