| Drug-eluting stent thrombosis: results from the multicenter Spanish registry ESTROFA (Estudio ESpañol sobre TROmbosis de stents FArmacoactivos). | |
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MedLine Citation:
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PMID: 18325436 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Journal Article; Multicenter Study |
Journal Detail:
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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:
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Created Date: 2008-03-07 Completed Date: 2008-03-11 Revised Date: 2010-08-16 |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 986-90 Citation Subset: AIM; IM |
Affiliation:
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Hospital Marques de Valdecilla, Santander, Spain. he1thj@humv.es |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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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:
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33069-62-4/Paclitaxel; 53123-88-9/Sirolimus |
| Comments/Corrections | |
Comment In:
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EuroIntervention. 2008 Aug;4 Suppl C:C54-5
[PMID:
19202695
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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