Document Detail


Drug-eluting stent thrombosis: results from the multicenter Spanish registry ESTROFA (Estudio ESpañol sobre TROmbosis de stents FArmacoactivos).
MedLine Citation:
PMID:  18325436     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: This study sought to assess the incidence, predictors, and outcome of drug-eluting stent(DES) thrombosis in real-world clinical practice. BACKGROUND: The DES thromboses in randomized trials could not be comparable to those observed in clinical practice, frequently including off-label indications. METHODS: We designed a large-scale, nonindustry-linked multicentered registry, with 20 centers in Spain. The participant centers provided follow-up data for their patients treated with DES, reporting a detailed standardized form in the event of any angiography-documented DES-associated thrombosis occurring. RESULTS: Of 23,500 patients treated with DES, definite stent thrombosis(ST) developed in 301: 24 acute, 125 subacute, and 152 late. Of the late, 62 occurred >1 year(very late ST). The cumulative incidence was 2% at 3 years. Antiplatelet treatment had been discontinued in 95 cases(31.6%). No differences in incidences were found among stent types. Independent predictors for subacute ST analyzed in a subgroup of 14,120 cases were diabetes, renal failure, acute coronary syndrome, ST-segment elevation myocardial infarction, stent length, and left anterior descending artery stenting, and for late ST were ST-segment elevation myocardial infarction, stenting in left anterior descending artery, and stent length. Mortality at 1-year follow-up was 16% and ST recurrence 4.6%. Older age, left ventricular ejection fraction <45%, nonrestoration of Thrombolysis In Myocardial Infarction flow grade 3, and additional stenting were independent predictors for mortality. CONCLUSIONS: The cumulative incidence of ST after DES implantation was 2% at 3 years. No differences were found among stent types. Patient profiles differed between early and late ST. Short-term prognosis is poor, especially when restoration of normal flow fails.
Authors:
José M de la Torre-Hernández; Fernando Alfonso; Felipe Hernández; Jaime Elizaga; Marcelo Sanmartin; Eduardo Pinar; Iñigo Lozano; Jose M Vazquez; Javier Botas; Armando Perez de Prado; Jose M Hernández; Juan Sanchis; Juan M Ruiz Nodar; Alfredo Gomez-Jaume; Mariano Larman; Jose A Diarte; Javier Rodríguez-Collado; Jose R Rumoroso; Jose R Lopez-Minguez; Josepa Mauri;
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Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  51     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-03-07     Completed Date:  2008-03-11     Revised Date:  2010-08-16    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  986-90     Citation Subset:  AIM; IM    
Affiliation:
Hospital Marques de Valdecilla, Santander, Spain. he1thj@humv.es
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Transluminal, Percutaneous Coronary
Coronary Disease / therapy
Coronary Thrombosis / epidemiology,  etiology*,  therapy
Disease-Free Survival
Drug-Eluting Stents / adverse effects*
Female
Humans
Kaplan-Meiers Estimate
Male
Middle Aged
Multivariate Analysis
Myocardial Infarction / physiopathology,  therapy
Paclitaxel / administration & dosage
Proportional Hazards Models
Registries
Sirolimus / administration & dosage
Stroke Volume
Chemical
Reg. No./Substance:
33069-62-4/Paclitaxel; 53123-88-9/Sirolimus
Comments/Corrections
Comment In:
EuroIntervention. 2008 Aug;4 Suppl C:C54-5   [PMID:  19202695 ]

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


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