Document Detail


Stent thrombosis in the modern era: a pooled analysis of multicenter coronary stent clinical trials.
MedLine Citation:
PMID:  11306525     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: There are limited studies of stent thrombosis in the modern era of second-generation stents, high-pressure deployment, and current antithrombotic regimens. METHODS AND RESULTS: Six recently completed coronary stent trials and associated nonrandomized registries that enrolled 6186 patients (6219 treated vessels) treated with >/=1 coronary stent followed by antiplatelet therapy with aspirin and ticlopidine were pooled for this analysis. Within 30 days, clinical stent thrombosis developed in 53 patients (0.9%). The variables most significantly associated with the probability of stent thrombosis were persistent dissection NHLBI grade B or higher after stenting (OR, 3.7; 95% CI, 1.9 to 7.7), total stent length (OR, 1.3; 95% CI, 1.2 to 1.5 per 10 mm), and final minimal lumen diameter within the stent (OR, 0.4; 95% CI, 0.2 to 0.7 per 1 mm). Stent thrombosis was documented by angiography in 45 patients (0.7%). Clinical consequences of angiographic stent thrombosis included 64.4% incidence of death or myocardial infarction at the time of stent thrombosis and 8.9% 6-month mortality. CONCLUSIONS: Stent thrombosis occurred in <1.0% of patients undergoing stenting of native coronary artery lesions and receiving routine antiplatelet therapy with aspirin plus ticlopidine. Procedure-related variables of persistent dissection, total stent length, and final lumen diameter were significantly associated with the probability of stent thrombosis. Continued efforts to eliminate this complication are warranted given the serious clinical consequences.
Authors:
D E Cutlip; D S Baim; K K Ho; J J Popma; A J Lansky; D J Cohen; J P Carrozza; M S Chauhan; O Rodriguez; R E Kuntz
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Publication Detail:
Type:  Journal Article; Meta-Analysis    
Journal Detail:
Title:  Circulation     Volume:  103     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2001 Apr 
Date Detail:
Created Date:  2001-04-18     Completed Date:  2001-05-10     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1967-71     Citation Subset:  IM    
Affiliation:
University of Rochester Medical Center, Rochester, NY, USA.
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MeSH Terms
Descriptor/Qualifier:
Aspirin / therapeutic use
Blood Vessel Prosthesis Implantation
Causality
Coronary Disease / drug therapy,  surgery
Coronary Thrombosis / epidemiology*,  mortality
Endpoint Determination
Female
Graft Occlusion, Vascular / epidemiology*,  mortality
Humans
Incidence
Logistic Models
Male
Middle Aged
Multicenter Studies as Topic
Myocardial Revascularization
Odds Ratio
Platelet Aggregation Inhibitors / therapeutic use
Randomized Controlled Trials as Topic
Survival Rate
Ticlopidine / therapeutic use
Treatment Outcome
Chemical
Reg. No./Substance:
0/Platelet Aggregation Inhibitors; 50-78-2/Aspirin; 55142-85-3/Ticlopidine

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


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