title: Acute infection-inflammation and coronary stent thrombosis: an observational study.
abstract: Coronary stent thrombosis (CST) is a major concern of interventional cardiology. Several risk factors for CST have been identified, but as a whole they do not explain the pathophysiology of CST. This study was designed to investigate whether acute infection-inflammation could facilitate the occurrence of CST. Forty-one patients, aged 66.6 +/- 11 years, consecutively admitted to our catheterization laboratory for acute, subacute or late CST, were retrospectively analysed. Transient acute infection-inflammation on admission for CST was diagnosed by predefined criteria. Prevalence of known risk factors for CST was also investigated. Twenty-one patients (51%) met predefined criteria for the occurrence of acute infection-inflammation. On admission, in these patients, levels of systemic humoral and cellular inflammatory markers were significantly higher than those of patients without recent or ongoing acute infection-inflammation (p < 0.05 for all). 62% of patients with acute infection-inflammation had less than two known risk factors for CST whereas only 37% patients without infection-inflammation showed less than two risk factors (p = 0.03) and showed more frequent interruption of antiplatelet treatment (17 vs. 2.4%, p = 0.02), mean longer stent length (20.5 +/- 4.8 vs. 16.5 +/- 5.1 mm, p = 0.02) and lower left ventricular ejection fraction before CST (42.9 +/- 14 vs. 47.3 +/- 11%, p = 0.02). In conclusion, acute infection-inflammation could play a role in facilitating the occurrence of CST in a subgroup with low risk profile for known risk factors. Our findings, if confirmed, could suggest new opportunities for prevention and treatment of CST.
authors.affiliation: Department of Heart and Vessels, Azienda Ospedaliera-Universitaria Careggi, University of Florence, Viale Morgagni 85, 50134, Florence, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Del Pace
authors.forename: Maria
authors.initials: M
authors.lastname: Boddi
authors.forename: Raffaele
authors.initials: R
authors.lastname: Rasoini
authors.forename: Serena
authors.initials: S
authors.lastname: Micheli
authors.forename: Camilla
authors.initials: C
authors.lastname: Alderighi
authors.forename: Sabina
authors.initials: S
authors.lastname: Caciolli
authors.forename: Massimo
authors.initials: M
authors.lastname: Margheri
authors.forename: Rosanna
authors.initials: R
authors.lastname: Abbate
authors.forename: Gian Franco
authors.initials: GF
authors.lastname: Gensini
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D023903:Coronary Restenosis / Q000453:epidemiology / Q000209:etiology*; D003328:Coronary Thrombosis / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D007239:Infections / Q000150:complications*; D007249:Inflammation / Q000150:complications* / Q000209:etiology; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents / Q000009:adverse effects; D013318:Stroke Volume; D016277:Ventricular Function, Left