Abstract 2561: Incidence and Correlates of Drug-Eluting Stent Thrombosis in a Series of 215 Patients with Definite/Probable Stent Thrombosis
Background: Stent thrombosis (ST) is a grave adverse outcome of DES use.
Methods: Definite (DST) and definite/probable ST (DPST) by Academic Research Consortium definitions among the 7926 patients who underwent unrestricted PCI with DES since April 2003 were examined. ST occurred in 215 patients.
Results: Baseline demographics were similar: 65.5% male with mean age 64.3 ± 13.0. The DST group had a higher incidence of MI during admit, diabetes, and heart failure. DPST had a higher incidence of MI during admit, cardiogenic shock, diabetes, heart failure, renal disease, and restenosis. A multivariate model found DST to be independently associated with heart failure and MI during admit and DPST independently associated with heart failure, diabetes, restenosis, and MI during admit. Clopidogrel cessation was associated with DST at 30 days but not 1 or 2 years. Outcomes were much worse among ST patients with higher incidence of death and MI up to 2 years in DST and DPST patients. (Table⇓) DST occurred early in 64% of patients, late in 21% and very late in 15%. The slope of the ST curve lessened with time. (Figure⇓)
Conclusions: DES ST is an infrequent but highly morbid event associated with MI during admit and heart failure. Careful consideration is warranted with DES use in acute MI. Most events occur within 30 days, but the risk continues beyond 2 years, although the incidence appears to be leveling off with time.