Abstract 17101: Incidence and Predictors of Recurrent Stent Thrombosis: Analysis of a Multicenter Stent Thrombosis Registry
Background: A subset of patients with stent thrombosis (ST) develop recurrent ST (rST).
Methods: We analyzed a multi-center California registry comprising all cases of angiographic definite ST at five academic hospitals from 2005-2013. We compared demographic, procedural, angiographic, and outcomes variables for subjects with definite (angiographically confirmed) and probable (unexplained death within 30 days after ST) rST compared to subjects with only one episode of ST.
Results: Among 216 patients, 29 developed definite or probable rST, and 19 developed angiographic definite rST. The median time to recurrent definite/probable rST was 40 days (IQR 4-156 days) and the median time to angiographic definite rST was 126 days (IQR 40-499 days). By Kaplan-Meier analysis, the estimated one-year event rate for occurrence of definite/probable rST was 15%, and 11% for occurrence of angiographic definite rST. Patients with definite or probable rST had similar baseline demographics to those without rST (Table 1). All patients were discharged on dual antiplatelet therapy after the initial ST event. Patients who developed rST were more likely to have initial ST of a bifurcation lesion (39% vs. 12% p value =0.001) and a larger proximal vessel reference diameter (mean 3.4 ± 0.7 mm vs. 3.0 ± 0.6 mm p value=0.01). Both bifurcation ST (HR 5.5, 95% CI 1.8-17.3) and larger reference vessel diameter (HR 2.3, 95% CI 1.1-5.2) remained significant predictors of rST on multivariable analysis.
Conclusion: The one year event rate of rST is approximately 15% in patients with an initial ST. ST at a bifurcation and larger proximal vessel diameter are independent predictors of rST.
- © 2013 by American Heart Association, Inc.