Long-term health outcome and mortality evaluation after invasive coronary treatment using drug-eluting stents: HOME DES registry.
OBJECTIVE
To assess the occurrence of late clinical events after the discontinuation of dual antiplatelet treatment in patients with drug-eluting stent implantation, complex coronary artery disease and high clinical risk profile.


METHODS
Between January 2004 and December 2005, 2080 patients underwent percutaneous coronary intervention, including 276 patients (13%) who were treated with drug-eluting stents. At the 6-month follow-up, 273 patients remained event-free and of these, 171 completed the 12-month and 18-month follow-ups and have been enrolled in the analysis. Dual antiplatelet treatment was administered for 6 months in all patients.


RESULTS
At the 18-month follow-up, stent thrombosis had occurred in 10 patients (5.8%), resulting in five sudden deaths and five target-vessel nonfatal myocardial infarctions. The majority (80%) of the events had developed within 7-12 months. The larger stent area and left main interventions were significantly associated with stent thrombosis (P=0.031 and P=0.001, respectively).


CONCLUSIONS
Our study confirmed worrisome results concerning drug-eluting stent thrombosis after the discontinuation of dual antiplatelet treatment. The rate of stent thrombosis-related events in our high-risk cohort of patients reached almost 6% with a 50% mortality. The majority (80%) of the events occurred within the months 7-12.
Cervinka
Pavel
P
Department of Cardiology, Masaryk hospital, Ustí nad Labem, Czech Republic. pavel.cervinka@mnul.cz
Jakabcin
Jozef
J
Jäger
Jiri
J
Veselka
Josef
J
Kala
Petr
P
Maly
Jaroslav
J
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation / Q000379:methods*; D015331:Cohort Studies; D003251:Constriction, Pathologic; D003324:Coronary Artery Disease / Q000401:mortality* / Q000628:therapy*; D018572:Disease-Free Survival; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000494:pharmacology; D012042:Registries; D012306:Risk; D013927:Thrombosis; D016896:Treatment Outcome
D010975:Platelet Aggregation Inhibitors