Abstract 14814: Timing of Very Late Stent Thrombosis Occurrence After Drug-eluting Stent and Bare-metal Stent Implantations
Background: Recently, very late stent thrombosis (VLST) after drug-eluting stent (DES) implantation has been reported. However, there is no data available to compare the characteristics of VLST after DES and bare-metal stent (BMS) implantations. We compared the clinical characteristics of VLST after DES and BMS implantations.
Methods: From April 1994 to March 2009, 9798 patients (14177 lesions) were treated with BMS and 4929 patients (7988 lesions) were treated with DES. In these patients, we retrospectively reviewed clinical data of the patients with VLST. VLST was defined as stent thrombosis according to the Academic Research Consortium definition which occurred later than 1 year after procedure.
Results: VLST occurred in 33 patients (33 lesions) after BMS implantation and 25 patients (27 lesions) after DES implantation. The figure shows that the timing of VLST occurrence after BMS implantation was much later than after DES implantation (BMS: 88.4±33.1 months, DES: 33.9±11.9 months, p<0.001). Especially, no VLST after BMS implantation occurred within 50 months after procedure. Although the rate of patients who continued dual antiplatelet therapy (DAPT) was similar (BMS: 15.2%, DES: 32.0%, p=0.203), that of patients with VLST who discontinued DAPT for surgery was significantly higher after DES implantation than after BMS implantation (BMS: 0%, DES: 12%, p=0.030).
Conclusions: It was clear that the timing of VLST occurrence after DES implantation was different from that after BMS implantation. When patient follow-up is performed, the period after stent implantation and effects of DAPT discontinuation for surgery should be taken into consideration.
- © 2011 by American Heart Association, Inc.