title: Late coronary stent thrombosis: early vs. late stent thrombosis in the stent era.
abstract: The incidence of coronary stent thrombosis is < 1%-2% in recent studies, with the highest-risk period considered to be the first 30 days following stent implantation. Recently, stent thrombosis after 30 days has been reported in patients undergoing brachytherapy with stenting. We reviewed the incidence of stent thrombosis causing myocardial infarction in nonbrachytherapy patients at our institution between 1 January 1996 and 30 November 1999. A case control methodology was employed with a 1:3 ratio of stent thrombosis to control patients. Of 1,191 patients undergoing coronary stenting, acute (< 24 hr) plus subacute (1-30 days) stent thrombosis occurred in 0.92% (11 of 1,191 patients). A further 0.76% (9 of 1,191 patients) developed late stent thrombosis after 30 days. There were no clinical or angiographic features at the time of the initial procedure that were associated with stent thrombosis as an entire group compared with control group, but early (acute and subacute) stent thrombosis patients had a smaller final stent minimal lumen diameter and longer stent length compared with patients who had late stent thrombosis or controls. Late stent thrombosis occurs in nonbrachytherapy patients and is almost as frequent as early stent thrombosis. Further studies are required to determine whether longer-term poststent pharmacological treatment may decrease or prevent this complication.
authors.affiliation: Department of Internal Medicine, Division of Cardiology, University of Texas Medical Branch at Galveston, 301 University Boulevard, Galveston, TX 77555, USA.
authors.forename: Fenwei
authors.initials: F
authors.lastname: Wang
authors.forename: George A
authors.initials: GA
authors.lastname: Stouffer
authors.forename: Sergio
authors.initials: S
authors.lastname: Waxman
authors.forename: Barry F
authors.initials: BF
authors.lastname: Uretsky
mesh_terms: D015415:Biomarkers / Q000097:blood; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation; D017023:Coronary Angiography; D003328:Coronary Thrombosis / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D011183:Postoperative Complications / Q000209:etiology; D011475:Prosthesis Failure; D012086:Reoperation; D015607:Stents / Q000009:adverse effects*; D013781:Texas / Q000453:epidemiology; D013997:Time Factors
chemical_list: D015415:Biomarkers