Stent thrombosis in 2008: definition, predictors, prognosis and treatment.
Stent thrombosis remains a major pitfall of stent implantation in contemporary percutaneous coronary intervention, leading to high rates of death and nonfatal myocardial infarction (MI). Recently, the emergence of drug-eluting stents (DES) has raised concerns regarding the occurrence of late and very late stent thrombosis. Last year, a standardized definition of stent thrombosis was established to provide consistency in the reporting of this complication and to enable accurate and reliable data to be described for both types of stents: bare metal and drug eluting. Subsequent to the publication of this new definition, many updated data have been reported in the literature. On the other hand, antiplatelet therapy response variability is a recent concept and its real place in the pathogenesis of stent thrombosis is yet to be determined. In this article, we review the definition of and predictors for stent thrombosis focusing on DES use and variability in response to antiplatelet therapy, prognosis and treatment.
Lemesle
Gilles
G
Service de cardiologie B et d'hémodynamique, hôpital cardiologique, CHRU de Lille, boulevard du Professeur-Jules-Leclercq, 59037 Lille, France.
Delhaye
Cédric
C
Bonello
Laurent
L
de Labriolle
Axel
A
Waksman
Ron
R
Pichard
Augusto
A
D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation*; D004351:Drug Resistance; D054855:Drug-Eluting Stents; D006801:Humans; D015994:Incidence; D008670:Metals; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D011474:Prosthesis Design; D012307:Risk Factors; D015607:Stents; D009626:Terminology as Topic; D013927:Thrombosis / Q000209:etiology / Q000473:pathology / Q000628:therapy; D013997:Time Factors; D016896:Treatment Outcome
D008670:Metals; D010975:Platelet Aggregation Inhibitors