Document Detail


ST-segment elevation myocardial infarction due to early and late stent thrombosis a new group of high-risk patients.
MedLine Citation:
PMID:  18565395     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The aim of this retrospective study was to compare clinical and angiographic outcomes between patients presenting with ST-segment elevation myocardial infarction (STEMI) due to stent thrombosis (ST) and de novo coronary thrombosis. BACKGROUND: There are limited data for procedural and mid-term outcomes of patients with ST presenting with STEMI. METHODS: From January 2004 to March 2007, 115 definite ST patients were observed: 92 (80%) of them presented as STEMI and were compared with a consecutive group of 98 patients with de novo STEMI. All patients underwent primary percutaneous coronary intervention. Primary end points were successful angiographic reperfusion and distal embolization. Major adverse cardiovascular and cerebrovascular events (MACCE), evaluated at 6-month follow-up, were defined as death, nonfatal myocardial reinfarction, target vessel revascularization, and cerebrovascular accident. RESULTS: Successful reperfusion rate was lower in patients with ST (p < 0.0001), whereas distal embolization rate was higher (p = 0.01) in comparison with patients with de novo STEMI. Stent thrombosis proved to be an independent predictor of unsuccessful reperfusion at propensity-adjusted binary logistic regression (odds ratio 6.8, p = 0.004). In-hospital MACCE rate was higher in patients with ST (p = 0.003), whereas no differences were observed at 6-month follow-up among hospital survivors between the 2 groups (p = 0.7). CONCLUSIONS: Stent thrombosis identifies a subgroup of patients with STEMI with poor angiographic and early clinical outcomes, suggesting that the management of these patients should be improved.
Authors:
Tania Chechi; Sabine Vecchio; Guido Vittori; Gabriele Giuliani; Alessio Lilli; Gaia Spaziani; Lorenzo Consoli; Giorgio Baldereschi; Giuseppe G L Biondi-Zoccai; Imad Sheiban; Massimo Margheri
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  51     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-06-20     Completed Date:  2008-07-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2396-402     Citation Subset:  AIM; IM    
Affiliation:
Cardiologia e Cardiologia Invasiva 2, A.O.U. Careggi, Florence, Italy.
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MeSH Terms
Descriptor/Qualifier:
Aged
Coronary Angiography
Coronary Thrombosis / complications*,  mortality,  physiopathology
Drug-Eluting Stents / adverse effects*
Female
Follow-Up Studies
Heart Conduction System / physiopathology*
Humans
Italy
Male
Middle Aged
Myocardial Infarction / etiology*,  mortality,  physiopathology
Myocardial Reperfusion
Retrospective Studies
Risk Factors
Time Factors
Treatment Outcome
Comments/Corrections
Comment In:
J Am Coll Cardiol. 2008 Jun 24;51(25):2403-6   [PMID:  18565396 ]

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