| Mechanisms of nonfatal acute myocardial infarction late after stent implantation: the relative impact of disease progression, stent restenosis, and stent thrombosis. | |
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MedLine Citation:
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PMID: 20211307 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Dimitrios Alexopoulos; Ioanna Xanthopoulou; Periklis Davlouros; Anastasia Damelou; Andreas Mazarakis; John Chiladakis; George Hahalis |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: American heart journal Volume: 159 ISSN: 1097-6744 ISO Abbreviation: Am. Heart J. Publication Date: 2010 Mar |
Date Detail:
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Created Date: 2010-03-09 Completed Date: 2010-04-02 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0370465 Medline TA: Am Heart J Country: United States |
Other Details:
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Languages: eng Pagination: 439-45 Citation Subset: AIM; IM |
Affiliation:
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Cardiology Department, Patras University Hospital, Rio, Patras, Greece. |
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Coronary Angiography Coronary Disease / physiopathology*, therapy* Coronary Restenosis / etiology*, radiography Disease Progression Drug-Eluting Stents / adverse effects Female Humans Male Middle Aged Myocardial Infarction / etiology*, radiography Stents / adverse effects* Thrombosis / etiology* Time Factors |
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