title: A clinical risk score for the prediction of very late stent thrombosis in drug eluting stent patients.
abstract: OBJECTIVE
  Very late stent thrombosis (VLST; >1 year) is an infrequent but potentially serious complication, whose risk factors have not been fully elucidated. This investigation sought to develop a clinically useful risk stratification score for VLST following drug eluting stent (DES) placement.
  
  
  RESULTS
  A Cox proportional hazards multivariate model of VLST was developed based on follow-up into a second year of patients enrolled in the ARRIVE registries, utilising readily available baseline clinical and angiographic characteristics. ST predictors between one and two years were identified among 7,459 consecutively enrolled patients who received a TAXUS® Express2™ (Boston Scientific, Natick, MA, USA) DES. Six significant predictors were found: presence of renal disease, prior myocardial infarction, multiple stenting, bifurcation lesions, prior CABG, and smoking at baseline. Each predictor was assigned a score, then summed for a maximum possible score of 10. Stratification into low and high risk groups revealed that VLST developed in 0.5% of 6,759 patients with scores<5, and 2.6% of 700 patients with scores≥5.
  
  
  CONCLUSIONS
  We defined a VLST risk score for patients during the second year post DES-placement that provides a useful tool for risk stratification.
authors.affiliation: United Heart Clinic, Nasseff Heart and Vascular Center, St. Paul, MN 55102, USA. kbaran@stphc.com
authors.forename: Kenneth W
authors.initials: KW
authors.lastname: Baran
authors.forename: John M
authors.initials: JM
authors.lastname: Lasala
authors.forename: David A
authors.initials: DA
authors.lastname: Cox
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Mascioli
authors.forename: Aijun
authors.initials: A
authors.lastname: Song
authors.forename: Mahesh C
authors.initials: MC
authors.lastname: Deshpande
authors.forename: Mary V
authors.initials: MV
authors.lastname: Jacoski
authors.forename: Keith D
authors.initials: KD
authors.lastname: Dawkins
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects* / Q000706:statistics & numerical data; D003324:Coronary Artery Disease / Q000453:epidemiology*; D003328:Coronary Thrombosis / Q000175:diagnosis / Q000453:epidemiology*; D054855:Drug-Eluting Stents / Q000009:adverse effects* / Q000706:statistics & numerical data; D005500:Follow-Up Studies; D006801:Humans; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012372:ROC Curve; D012042:Registries / Q000706:statistics & numerical data; D018570:Risk Assessment; D012307:Risk Factors