Abstract 16453: Drug-Eluting Stent Event Registry of Thrombosis (DESERT): The International Drug-Eluting Stent Thrombosis Registry
Background: Stent thrombosis (ST) frequently presents as an acute event triggering myocardial infarction (MI) or death. Given the low ST event rates, single-center studies are limited when evaluating this phenomenon. It is important to understand the predicting factors of ST and to define which patients are at high risk. This registry aims to evaluate predictors and outcome of late drug-eluting stent (DES) ST.
Methods: 982 patients, 491 case-control pairs, from 21 sites in the USA, Canada and Switzerland were enrolled into this multicenter, observational, case-control study of definite, late, or very late ST in patients with DES. Cases were identified by presentation with definite ST (ARC definition). Controls were matched according to three criteria: same enrolling institute, date of initial DES implantation, and no known history of ST.
Results: The average time from DES implantation to ST presentation was 897.68 ± 652.82 days. Patients who presented with ST were older and more likely to be African American, current smokers, with history of prior MI, hypertension, and lower LV ejection fraction. They presented for stent implantation more frequently for STEMI, received more IIB/IIIA inhibitors initially, had more Type C lesions treated and in-stent restenotic lesions as well as target lesion thrombus present during the initial DES implantation. Additionally, the patients who presented with ST had longer lesions treated with a longer-length stent and more stents per patient. Half of the overall lesions received sirolimus-eluting stents (50.2%), paclitaxel-eluting stents in 40.3%, everolimus-eluting stents in 7.0%, and zotarolimus-eluting stents in 1.8%. There was no difference between the matched groups with respect to stent distribution. Univariable analysis is shown in the Table.
Conclusions: These data demonstrate a significant difference in baseline demographics and indication for initial DES implantation between the case and control groups.
- © 2012 by American Heart Association, Inc.