title: Contemporary clinical characteristics, treatment, and outcomes of angiographically confirmed coronary stent thrombosis: results from a multicenter California registry.
abstract: OBJECTIVE
  To describe the contemporary treatment and outcomes for patients with angiographically confirmed (definite) stent thrombosis (ST).
  
  
  BACKGROUND
  Limited data are available on contemporary treatment patterns and outcomes of patients with ST in the United States.
  
  
  METHODS
  In this multicenter California registry, consecutive cases of definite ST over 5 years were identified. Clinical characteristics, in-hospital outcomes, and long-term survival are reported.
  
  
  RESULTS
  One hundred and sixty five consecutive episodes of ST were identified in 153 patients from January 2005 to February 2010. The distribution of acute (≤24 hr), subacute (24 hr to 30 days), late (30 days to 1 year), and very late (≥1 year) ST was 3.9%, 21.8%, 17.6%, and 50.3%, respectively. Only 41.2% of patients were on dual antiplatelet therapy at the time of presentation, while 22.4% of patients were on none. Of the 61.4% of patients treated with restenting, 71.1% of them received a drug-eluting stent. Procedural success was 88.1%, and in-hospital death, stroke, and CABG occurred in 5.5%, 0.6%, and 6.1% of subjects, respectively. All-cause mortality at 1 year was 14.3%. Although female gender, diabetes mellitus (DM), bifurcation disease, ejection fraction <40%, and cardiogenic shock at the time of presentation were associated with an increased risk of in-hospital mortality, only DM (P = 0.047) and bifurcation disease (P = 0.027) remained independent predictors of in-hospital death.
  
  
  CONCLUSIONS
  In-hospital mortality from definite ST is lower than previously reported, but long-term mortality remains high. DM and bifurcation disease, but not type of percutaneous therapy, are independently associated with in-hospital mortality.
authors.affiliation: University of California, Davis Medical Center, Sacramento, California, USA.
authors.forename: Khung Keong
authors.initials: KK
authors.lastname: Yeo
authors.forename: Ehtisham
authors.initials: E
authors.lastname: Mahmud
authors.forename: Ehrin J
authors.initials: EJ
authors.lastname: Armstrong
authors.forename: William E
authors.initials: WE
authors.lastname: Bennett
authors.forename: Kendrick A
authors.initials: KA
authors.lastname: Shunk
authors.forename: John S
authors.initials: JS
authors.lastname: MacGregor
authors.forename: Zhongmin
authors.initials: Z
authors.lastname: Li
authors.forename: Reginald I
authors.initials: RI
authors.lastname: Low
authors.forename: Jason H
authors.initials: JH
authors.lastname: Rogers
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects* / Q000295:instrumentation* / Q000401:mortality; D002140:California; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D054855:Drug-Eluting Stents; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011237:Predictive Value of Tests; D011474:Prosthesis Design; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D015607:Stents; D020521:Stroke / Q000209:etiology; D016019:Survival Analysis; D017131:Thrombectomy / Q000009:adverse effects / Q000401:mortality; D015912:Thrombolytic Therapy / Q000009:adverse effects / Q000401:mortality; D013927:Thrombosis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D010975:Platelet Aggregation Inhibitors