title: Stent thrombosis is the primary cause of ST-segment elevation myocardial infarction following coronary stent implantation: a five year follow-up of the SORT OUT II study.
abstract: BACKGROUND
  The widespread use of coronary stents has exposed a growing population to the risk of stent thrombosis, but the importance in terms of risk of ST-segment elevation myocardial infarctions (STEMIs) remains unclear.
  
  
  METHODS
  We studied five years follow-up data for 2,098 all-comer patients treated with coronary stents in the randomized SORT OUT II trial (mean age 63.6 yrs. 74.8% men). Patients who following stent implantation were readmitted with STEMI were included and each patient was categorized ranging from definite- to ruled-out stent thrombosis according to the Academic Research Consortium definitions. Multivariate logistic regression was performed on selected covariates to assess odds ratios (ORs) for definite stent thrombosis.
  
  
  RESULTS
  85 patients (4.1%), mean age 62.7 years, 77.1% men, were admitted with a total of 96 STEMIs, of whom 60 (62.5%) had definite stent thrombosis. Notably, definite stent thrombosis was more frequent in female than male STEMI patients (81.8% vs. 56.8%, p =  .09), and in very late STEMIs (p = 0.06). Female sex (OR 3.53 [1.01-12.59]) and clopidogrel (OR 4.43 [1.03-19.01]) was associated with increased for definite stent thrombosis, whereas age, time since stent implantation, use of statins, initial PCI urgency (STEMI [primary PCI], NSTEMI/unstable angina [subacute PCI] or stable angina [elective PCI]), and glucose-lowering agents did not seem to influence risk of stent thrombosis.
  
  
  CONCLUSIONS
  In a contemporary cohort of coronary stented patients, stent thrombosis was evident in more than 60% of subsequent STEMIs.
authors.affiliation: Department of Cardiology, Copenhagen University Hospital Roskilde, Roskilde, Denmark; Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, Denmark.
authors.forename: Søren Lund
authors.initials: SL
authors.lastname: Kristensen
authors.affiliation: Department of Cardiology, Copenhagen University Hospital Roskilde, Roskilde, Denmark.
authors.forename: Anders M
authors.initials: AM
authors.lastname: Galløe
authors.affiliation: Department of Medicine, Aarhus University Hospital Herning, Herning, Denmark.
authors.forename: Leif
authors.initials: L
authors.lastname: Thuesen
authors.affiliation: The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
authors.forename: Henning
authors.initials: H
authors.lastname: Kelbæk
authors.affiliation: Department of Cardiology, Odense Universy Hospital, Odense, Denmark.
authors.forename: Per
authors.initials: P
authors.lastname: Thayssen
authors.affiliation: Department of Cardiology, Copenhagen University Hospital Roskilde, Roskilde, Denmark.
authors.forename: Ole
authors.initials: O
authors.lastname: Havndrup
authors.affiliation: Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, Denmark.
authors.forename: Peter Riis
authors.initials: PR
authors.lastname: Hansen
authors.affiliation: Department of Cardiology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark.
authors.forename: Niels
authors.initials: N
authors.lastname: Bligaard
authors.affiliation: The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
authors.forename: Kari
authors.initials: K
authors.lastname: Saunamäki
authors.affiliation: Department of Cardiology, Odense Universy Hospital, Odense, Denmark.
authors.forename: Anders
authors.initials: A
authors.lastname: Junker
authors.affiliation: Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark.
authors.forename: Jens
authors.initials: J
authors.lastname: Aarøe
authors.affiliation: Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, Denmark.
authors.forename: Ulrik
authors.initials: U
authors.lastname: Abildgaard
authors.affiliation: Department of Medicine, Copenhagen University Hospital Glostrup, Glostrup, Denmark.
authors.forename: Jørgen L
authors.initials: JL
authors.lastname: Jeppesen
mesh_terms: D000368:Aged; D060050:Angina, Stable / Q000150:complications; D000077144:Clopidogrel; D015331:Cohort Studies; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000737:chemistry / Q000627:therapeutic use; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology*; D016017:Odds Ratio; D062645:Percutaneous Coronary Intervention; D010975:Platelet Aggregation Inhibitors / Q000737:chemistry / Q000627:therapeutic use; D013927:Thrombosis / Q000150:complications / Q000628:therapy*; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000737:chemistry / Q000627:therapeutic use
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine