Incidence and predictors of definite stent thrombosis after coronary stent implantation.
BACKGROUND
Coronary stents are widely used in percutaneous coronary intervention (PCI) procedures. We aimed to explore the incidence, predictors and characteristics of stent thrombosis (ST) after coronary stent implantation in routine clinical practice.


METHODS
From data of 18 063 consecutive patients who underwent successful stent implantation in Shenyang Northern Hospital from 2004 to 2010, we identified patients with definite ST (n = 140) and control patients (n = 280) matched on age, diagnosis, sex, current antiplatelet medication and stent type. The incidence, predictors and characteristics of ST after coronary stent implantation were investigated.


RESULTS
The incidence of angiographically confirmed ST was 0.78% (140/18 063). The time distribution of ST was acute in 43 (30.7%), subacute in 50 (35.7%), and late in 47 (33.6%) patients. Binary Logistic regression analysis identied the angiotensin-converting enzyme inhibitor (ACEI) (odds ratio (OR) = 0.472, 95%CI: 0.276 - 0.807, P = 0.006) and heparin (OR = 0.477, 95%CI: 0.278 - 0.819, P = 0.007) were associated with an reduced risk of cumulative ST. Stent length (OR = 1.042, 95%CI: 1.026 - 1.058, P < 0.001), serum creatinine total (OR = 1.020, 95%CI: 1.004 - 1.035, P = 0.04), cholesterol (OR = 1.267, 95%CI: 1.021 - 1.573, P = 0.032), glucose (OR = 1.086, 95%CI: 1.002 - 1.176, P = 0.044), and platelet aggregation (OR = 1.113, 95%CI: 1.075 - 1.154, P < 0.001) were associated with an increased risk of cumulative ST.


CONCLUSIONS
ST is associated with longer stent length and higher level of total cholesterol, glucose and platelet aggregation.
Department of Cardiology, Institute of Cardiovascular Research of People's Liberation Army, Shenyang Northern Hospital, Shenyang, Liaoning 110840, China.
Quan-Yu
QY
Zhang
Yi
Y
Li
Shao-Yi
SY
Guan
Xiao-Zeng
XZ
Wang
Quan-Min
QM
Jing
Ying-Yan
YY
Ma
Geng
G
Wang
Bin
B
Wang
Jie
J
Deng
Ya-Ling
YL
Han
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000378:metabolism; D017023:Coronary Angiography; D003328:Coronary Thrombosis / Q000453:epidemiology* / Q000209:etiology / Q000378:metabolism; D054855:Drug-Eluting Stents / Q000009:adverse effects; D005260:Female; D006493:Heparin / Q000378:metabolism; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000628:therapy
D000806:Angiotensin-Converting Enzyme Inhibitors; D006493:Heparin