title: Clinical presentations, antiplatelet strategies and prognosis of patients with stent thrombosis: an observational study of 140 patients.
abstract: BACKGROUND
  Until now there has been scarce evidence regarding an optimal antiplatelet strategy and clinical outcomes for patients who had suffered from stent thrombosis (ST).
  
  
  RESULTS
  140 patients who suffered from stent thrombosis were prospectively registered. Patients received dual (aspirin and 150 mg clopidogrel, N = 66) or triple (additional cilostazol, N = 74) antiplatelet therapy at the physician's discretion. Thereafter platelet reactivity and one year clinical outcomes were analyzed. The primary outcome included the composite of cardiac death, non-fatal myocardial infarction (MI) or stroke at one year,which developed in 41 (29.3%) patients, consisting of 31 (22.1%) cardiac death, 9 (6.4%) non-fatal MI and 1 (1.4%) stroke. Recurrent definite and probable ST according to ARC definition was observed in 8 (5.7%) and 14 (10.0%) patients, respectively. Triple therapy was associated with significantly lower platelet reactivities (50.2 ± 17.8, % vs. 59.6 ± 17.2, %, P = 0.002) compared to high dose dual antiplatelet therapy. However, the incidence of primary events (24.3% vs. 34.8%, P = 0.172) did not differ between triple and dual antiplatelet therapies. High on-treatment platelet reactivity (HR: 8.35, 95% CI: 2.234∼30.867, P = 0.002) and diabetes (HR: 3.732, 95% CI: 1.353∼10.298, P = 0.011) were independent predictors of primary events.
  
  
  CONCLUSIONS
  Patients who suffered from stent thrombosis have a poor prognosis even after revascularization with intensive antiplatelet therapy. Triple antiplatelet therapy was more effective in reducing on-treatment platelet reactivity, compared to high dose dual antiplatelet therapy.
authors.affiliation: Department of Cardiology, Shenyang Northern Hospital, Liaoning, China. hanyl@medmail.com.cn
authors.forename: Ya-Ling
authors.initials: YL
authors.lastname: Han
authors.forename: Quan-Yu
authors.initials: QY
authors.lastname: Zhang
authors.forename: Yi
authors.initials: Y
authors.lastname: Li
authors.forename: Shao-Yi
authors.initials: SY
authors.lastname: Guan
authors.forename: Quan-Min
authors.initials: QM
authors.lastname: Jing
authors.forename: Zu-Lu
authors.initials: ZL
authors.lastname: Wang
authors.forename: Xin
authors.initials: X
authors.lastname: Zhao
authors.forename: Xiao-Zeng
authors.initials: XZ
authors.lastname: Wang
authors.forename: Ying-Yan
authors.initials: YY
authors.lastname: Ma
authors.forename: Bin
authors.initials: B
authors.lastname: Wang
authors.forename: Jie
authors.initials: J
authors.lastname: Deng
authors.forename: Geng
authors.initials: G
authors.lastname: Wang
authors.forename: Young-Hak
authors.initials: YH
authors.lastname: Kim
mesh_terms: D000368:Aged; D017023:Coronary Angiography; D003328:Coronary Thrombosis / Q000175:diagnosis* / Q000188:drug therapy* / Q000209:etiology / Q000401:mortality; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D010979:Platelet Function Tests; D011379:Prognosis; D012372:ROC Curve; D012307:Risk Factors; D015607:Stents / Q000009:adverse effects*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D010975:Platelet Aggregation Inhibitors