Predictors of sub-acute stent thrombosis in acute myocardial infarction patients following primary coronary stenting with bare metal stent.
BACKGROUND
The aim of the present study was to identify the relationship between sub-acute stent thrombosis (SAT) and acute-phase inflammatory reactants, such as high-sensitivity C-reactive protein (hs-CRP) and serum amyloid-A protein (SAA), in patients with acute myocardial infarction (AMI) successfully treated with primary coronary stenting.


RESULTS
The 381 consecutive AMI subjects were reperfused by primary coronary stenting within 24 h of onset. SAT was confirmed angiographically in 10 patients (2.6%). There were no significant differences between the patients with or without SAT in terms of patient characteristics, Killip classification on admission, or stent diameter, nor were there significant differences between the 2 groups in terms of left ventricular function soon after stenting (left ventricular ejection fraction) or end-diastolic volume index. The plasma levels of both hs-CRP and SAA were significantly higher in the SAT patients than in the others (hs-CRP: 6.7+/-6.7 mg/dl vs 3.3+/-3.8 mg/dl, p=0.007; SAA: 699+/-812 mug/dl vs 208+/-273 mug/dl, p<0.0001). Multivariate analysis identified SAA as an independent predictor of SAT (risk ratio: 4.9, 95% confidence interval: 1.7-14.9, p<0.05).


CONCLUSIONS
In patients with AMI who are treated with primary coronary stenting, inflammation may be closely related to SAT, for which SAA is a useful predictor.
Katayama
Toshiro
T
Department of Cardiovascular Medicine and Course of Medical and Dental Science, Graduate School of Biomedical Science, Nagasaki University, 2-5-5-1615 Akasako, Nagasaki 852-8156, Japan. snowman-kt@syd.odn.ne.jp
Nakashima
Hiroshi
H
Takagi
Chisa
C
Honda
Yukiharu
Y
Suzuki
Shin
S
Iwasaki
Yoshihiro
Y
Yamamoto
Tadashi
T
Yoshioka
Masato
M
Yano
Katsusuke
K
D000208:Acute Disease; D000368:Aged; D015415:Biomarkers / Q000032:analysis; D002097:C-Reactive Protein / Q000032:analysis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000150:complications / Q000628:therapy; D011237:Predictive Value of Tests; D012307:Risk Factors; D000685:Serum Amyloid A Protein / Q000032:analysis*; D015607:Stents / Q000009:adverse effects; D013927:Thrombosis / Q000097:blood* / Q000209:etiology
D015415:Biomarkers; D000685:Serum Amyloid A Protein; D002097:C-Reactive Protein