Document Detail

Mechanisms of nonfatal acute myocardial infarction late after stent implantation: the relative impact of disease progression, stent restenosis, and stent thrombosis.
MedLine Citation:
PMID:  20211307     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The impact of stent restenosis, stent thrombosis, or progression of disease at another site as responsible mechanisms of acute myocardial infarction (AMI) after stent implantation is not clear. METHODS: By searching our catheterization laboratory database for a 4-year period, 91 cases of nonfatal AMI at least 1 month after stent implantation (32.6% drug-eluting stents) were identified. By detailed comparison of post-AMI with the initial percutaneous coronary intervention angiogram, the mechanism of AMI was analyzed. RESULTS: Acute myocardial infarction was attributed to disease progression at another site in 42 (46.2%), stent restenosis in 35 (38.4%), and stent thrombosis in 10 (11%) cases. The AMI mechanism could be either stent related or disease progression (nonidentifiable culprit lesion) in 4 cases (4.4%). The median time from percutaneous coronary intervention to AMI was 27, 19, and 9 months for disease progression at another site, restenosis, and stent thrombosis group, respectively (P = .03). ST-elevation myocardial infarction occurred in 38.1% of the disease progression, in 20% of the restenosis, and in 60% of the stent thrombosis cases (P = .046). CONCLUSIONS: In a "real world" population, late after stent implantation, a patient has an almost equal probability to have suffered a nonfatal AMI from either stent restenosis/thrombosis or disease progression at another site. Continuous research efforts are necessary to equally address both stent therapy and disease progression.
Dimitrios Alexopoulos; Ioanna Xanthopoulou; Periklis Davlouros; Anastasia Damelou; Andreas Mazarakis; John Chiladakis; George Hahalis
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American heart journal     Volume:  159     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-03-09     Completed Date:  2010-04-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  439-45     Citation Subset:  AIM; IM    
Cardiology Department, Patras University Hospital, Rio, Patras, Greece.
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MeSH Terms
Coronary Angiography
Coronary Disease / physiopathology*,  therapy*
Coronary Restenosis / etiology*,  radiography
Disease Progression
Drug-Eluting Stents / adverse effects
Middle Aged
Myocardial Infarction / etiology*,  radiography
Stents / adverse effects*
Thrombosis / etiology*
Time Factors

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

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