title: The risk and prognostic impact of definite stent thrombosis or in-stent restenosis after coronary stent implantation.
abstract: OBJECTIVE
  Data are limited on the prognostic impact of stent thrombosis and in-stent restenosis in patients treated with coronary stents. We examined the prognostic impact of stent thrombosis and in-stent restenosis in patients treated with percutaneous coronary intervention (PCI).
  
  
  RESULTS
  All patients who underwent stent implantation from 2002 to 2005 were identified in the Western Denmark Heart Registry. The hazard ratio (HR) for death associated with stent thrombosis or in-stent restenosis was estimated with a Cox regression analysis with stent thrombosis or in-stent restenosis as time-dependent variables. A total of 12,277 patients were treated with stent implantation. Stent thrombosis was observed in 111 (0.9%) patients and in-stent restenosis in 503 (4.1%) patients within 12 months after the index PCI. Occurrence of stent thrombosis was associated with an increased risk of death (HR=2.71 [95% CI: 1.72-4.27]) compared to cases without stent thrombosis. In-stent restenosis had no substantial impact (HR=1.17 [95% CI: 0.79-1.75]). However, in-stent restenosis presenting as non-ST-segment elevation myocardial infarction (NSTEMI) was associated with a greater mortality risk compared with presentation of in-stent restenosis without myocardial infarction (HR=3.11 [95% CI: 1.08-8.69]; p=0.036).
  
  
  CONCLUSIONS
  The occurrence of stent thrombosis and in-stent restenosis presenting with NSTEMI increased the mortality risk threefold whereas in-stent restenosis without myocardial infarction was not associated with an increased mortality risk.
authors.affiliation: Department of Cardiology, Odense University Hospital, Odense, Denmark. per.thayssen@ouh.regionsyddanmark.dk
authors.forename: Per
authors.initials: P
authors.lastname: Thayssen
authors.forename: Lisette Okkels
authors.initials: LO
authors.lastname: Jensen
authors.forename: Jens Flensted
authors.initials: JF
authors.lastname: Lassen
authors.forename: Hans Henrik
authors.initials: HH
authors.lastname: Tilsted
authors.forename: Anne
authors.initials: A
authors.lastname: Kaltoft
authors.forename: Evald Hoej
authors.initials: EH
authors.lastname: Christiansen
authors.forename: Knud Noerregaard
authors.initials: KN
authors.lastname: Hansen
authors.forename: Jan
authors.initials: J
authors.lastname: Ravkilde
authors.forename: Michael
authors.initials: M
authors.lastname: Maeng
authors.forename: Lars
authors.initials: L
authors.lastname: Krusell
authors.forename: Morten
authors.initials: M
authors.lastname: Madsen
authors.forename: Henrik Toft
authors.initials: HT
authors.lastname: Sørensen
authors.forename: Leif
authors.initials: L
authors.lastname: Thuesen
mesh_terms: D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D023903:Coronary Restenosis / Q000209:etiology* / Q000401:mortality; D003328:Coronary Thrombosis / Q000209:etiology* / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality; D011379:Prognosis; D016016:Proportional Hazards Models; D012306:Risk; D015607:Stents / Q000009:adverse effects*