Abstract 2217: Stent Thrombosis after Primary Angioplasty for Acute Myocardial Infarction: Insights from the Typhoon Trial
Background: The TYPHOON trial was a multicenter, randomized single-blinded trial comparing the implantation of a sirolimus-eluting stent (SES) to bare metal stents (BMS) during primary angioplasty for acute myocardial infarction (PAMI). 712 patients from 48 centers were enrolled. The primary endpoint, target vessel failure, was reduced from 14.3% in the BMS group to 7.3% in the SES group (P = 0.004). We sought to determine the predictors of stent thrombosis (ST) in this setting.
Methods: The ST rate at one year was similar between the groups (3.4% in the sirolimus-eluting stent group vs. 3.6% in the bare metal stent group, P = 1.0). A simple logistic regression analysis was performed using clinical and procedural variables to determine predictors of ST. Significant variables were then entered in a multivariate logistic regression analysis.
Results: Conclusion: No difference in one-year ST rates was found between the SES and BMS groups. Several patient-, lesion-, and procedure-related variables (age, lesion calcification, ejection fraction, multivessel disease, number of stents implanted, stent diameter) were identified as predictors of ST at one year. This data could be used to identify patients at high-risk for ST after PAMI, and allow implementation of preventive strategies such as prolonged antiplatelet therapy in selected cases.