Coronary stent thrombosis in patients with chronic renal insufficiency.
Renal insufficiency (RI) is a strong predictor of unfavorable outcomes after percutaneous coronary intervention (PCI). After PCI, stent thrombosis (ST) is a considerable concern. The risk of ST in RI has not been independently evaluated before. The mechanism of ST is frequently related to dual antiplatelet underuse. We reviewed the publications listed on Medline, Scopus, and EBSCO Host research database in the last two decades to identify the risk of ST in patients with RI. There are no enough data on the incidence of ST in RI patients. Platelet reactivity, appropriate period of dual antiplatelet therapy, coronary anatomy, selection of stent, and patient compliance are vital issues that warrant detailed evaluation in RI patients. Moreover, prospective trials and new therapeutic strategies are needed for proper assessment and management of ST in high-risk patients.
El-Menyar
Ayman
A
Department of Cardiology and Cardiovascular Surgery, Hamad General Hospital, HMC, Doha, Qatar. elmenyar@yahoo.com
Hussein
Hesham
H
Al Suwaidi
Jassim
J
D015906:Angioplasty, Balloon, Coronary; D001241:Aspirin / Q000627:therapeutic use; D000077144:Clopidogrel; D003328:Coronary Thrombosis / Q000209:etiology* / Q000517:prevention & control; D054855:Drug-Eluting Stents / Q000009:adverse effects; D006801:Humans; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000627:therapeutic use; D051436:Renal Insufficiency, Chronic / Q000150:complications*; D012307:Risk Factors; D015607:Stents / Q000009:adverse effects*; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000627:therapeutic use
D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin