Document Detail


Clinical presentation, management, and outcomes of angiographically documented early, late, and very late stent thrombosis.
MedLine Citation:
PMID:  22361596     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The aim of this study was to describe differences in treatment and in-hospital mortality of early, late, and very late stent thrombosis (ST).
BACKGROUND: Early, late, and very late ST may differ in clinical presentation, management, and in-hospital outcomes.
METHODS: We analyzed definite (angiographically documented) ST cases identified from February 2009 to June 2010 in the CathPCI Registry. We stratified events by timing of presentation: early (≤1 month), late (1 to 12 months), or very late (≥12 months) following stent implantation. Multivariable logistic regression modeling was performed to compare in-hospital mortality for each type of ST after adjusting for baseline comorbidities.
RESULTS: During the study period, 7,315 ST events were identified in 7,079 of 401,662 patients (1.8%) presenting with acute coronary syndromes. This ST cohort consisted of 1,391 patients with early ST (19.6%), 1,370 with late ST (19.4%), and 4,318 with very late ST (61.0%). Subjects with early ST had a higher prevalence of black race and diabetes, whereas subjects with very late ST had a higher prevalence of white race and a lower prevalence of prior myocardial infarction or diabetes. In-hospital mortality was significantly higher in early ST (7.9%) compared with late (3.8%) and very late ST (3.6%, p<0.001). This lower mortality for late and very late ST persisted after multivariable adjustment (odds ratio: 0.53 [95% confidence interval (CI): 0.36 to 0.79] and 0.58 [95% CI: 0.43 to 0.79], respectively).
CONCLUSIONS: Significant differences exist in the presentation and outcomes of early, late, and very late ST. Among patients with acute coronary syndromes who are undergoing percutaneous coronary intervention for angiographically documented ST, early ST is associated with the highest in-hospital mortality.
Authors:
Ehrin J Armstrong; Dmitriy N Feldman; Tracy Y Wang; Lisa A Kaltenbach; Khung-Keong Yeo; S Chiu Wong; John Spertus; Richard E Shaw; Robert M Minutello; Issam Moussa; Kalon K L Ho; Jason H Rogers; Kendrick A Shunk
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  JACC. Cardiovascular interventions     Volume:  5     ISSN:  1876-7605     ISO Abbreviation:  JACC Cardiovasc Interv     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-02-24     Completed Date:  2012-07-09     Revised Date:  2014-09-05    
Medline Journal Info:
Nlm Unique ID:  101467004     Medline TA:  JACC Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  131-40     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Balloon, Coronary / instrumentation
Confidence Intervals
Coronary Angiography / instrumentation*
Coronary Thrombosis / mortality*,  therapy
Drug-Eluting Stents*
Female
Hospital Mortality / trends
Humans
Logistic Models
Male
Middle Aged
Multivariate Analysis
Odds Ratio
Registries
Risk Assessment
Time Factors
Treatment Outcome
United States
Comments/Corrections
Comment In:
JACC Cardiovasc Interv. 2012 Feb;5(2):141-4   [PMID:  22361597 ]

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