Abstract 16792: Incidence and Predictors of Stent Thrombosis: A Review of 5,834 Consecutive Patients in a Single UK Centre
Introduction: Stent thrombosis (ST) is an infrequent but potentially fatal complication of PCI. The reported incidence of ST varies from 0.6% to 4.8% (e.g. TYPHOON Trial). This variation could be due differences in definition of ST, inclusion/exclusion criteria, type of stent and dual anti-platelet therapy (DAPT) used and geographical variations in risk factor profile. We aimed to examine the incidence of ST and associated risk factors in this “real-world, all-comers” single centre study.
Methods: All patients undergoing PCI at South Yorkshire Cardiothoracic Centre (UK) between January 2007 and February 2010 were included with no exclusion criteria and were followed up for 12 months.Data were collected from hospital and bereavement records. ST was defined according to ARC into definite, probable and possible ST and also categorized into early (<30 days) and late (30-365 days). Data are presented as Mean ± SD or percentage and analysed by student’s t-test, one-way ANOVA and Chi-square test, as appropriate. Variables with p≤0.1 were entered in a multiple regression model to identify factors independently associated with ST.
Results: A total of 5834 patients were included with mean age 63.1±11.6 years. Majority (71%) were males and had PCI for acute coronary syndromes/urgent indications (61%). The incidence of ST was 3.2% (n=188) with 0.9% (n=53) definite ST, 0.7% (n=39) probable ST and 1.6% (n=96) possible ST. 51 (0.9%) patients had early ST and 137 (2.3%) patients had late ST. We evaluated a large number of demographic, clinical and angiographic variables to identify factors independently associated with ST (Table).
Conclusion: Cardiogenic shock, heart failure, lack of DAPT, need for GPIIb/IIIa during procedure and use of longer stents are associated with ST. Knowledge of these factors may help clinicians to risk stratify PCI patients to ensure those at high risk get maximum preventative therapy or adjunctive imaging (IVUS/OCT) to optimise stent sizing and deployment.
- © 2012 by American Heart Association, Inc.