title: Prevalence and outcomes of non-ST-segment elevation myocardial infarction resulting from stent thrombosis.
abstract: OBJECTIVE
  Stent thrombosis is an infrequent yet one of the most feared complications after stent implantation. Stent thrombosis most commonly manifests as ST-segment elevation myocardial infarction, thus the data regarding non-ST-segment elevation myocardial infarction (NSTEMI) resulting from stent thrombosis are still sparse. The aim of the study is to evaluate the prevalence and outcomes of NSTEMI resulting from stent thrombosis.
  
  
  METHODS
  We performed a retrospective analysis of 378 consecutive NSTEMI patients who underwent coronary angiography. Patients were divided into those with and without stent thrombosis. The primary outcome was in-hospital mortality. Secondary outcome was the incidence of large myocardial infarction defined as a peak troponin I value greater than 90th percentile of the entire study population (26.5 μg/L).
  
  
  RESULTS
  Among 378 patients with NSTEMI, 12 (3.2%) patients had angiographically confirmed definite stent thrombosis. With respect to the timing of stent thrombosis, 2 patients had early, 3 had late and 7 had very-late stent thrombosis. Patients with stent thrombosis had a higher incidence of large myocardial infarction (33% vs. 9%, p = 0.02) and a higher albeit statistically insignificant peak troponin value (interquartile, 4.62 [0.19-64.0] μg/L vs. 1.21 [0.14-7.12] μg/L, p = 0.25) compared to those without stent thrombosis. There was no significant difference in in-hospital mortality between the two groups (8% vs. 2%, p = 0.2).
  
  
  CONCLUSIONS
  Stent thrombosis accounted for 3.2% cases of NSTEMI in our cohort of patients and patients with NSTEMI resulting from stent thrombosis had a higher incidence of large myocardial infarction.
authors: Department of Internal Medicine, Mount Sinai Beth Israel, NY, USA. Electronic address: nmisumida@chpnet.org.
authors: Naoki
authors: N
authors: Misumida
authors: Department of Internal Medicine, Mount Sinai Beth Israel, NY, USA.
authors: Akihiro
authors: A
authors: Kobayashi
authors: Department of Cardiology, Mount Sinai Beth Israel, NY, USA.
authors: Madeeha
authors: M
authors: Saeed
authors: Department of Cardiology, Mount Sinai Beth Israel, NY, USA.
authors: John T
authors: JT
authors: Fox
authors: Department of Cardiology, Mount Sinai Beth Israel, NY, USA.
authors: Yumiko
authors: Y
authors: Kanei
mesh_terms: D000368:Aged; D017023:Coronary Angiography / Q000379:methods; D054855:Drug-Eluting Stents / Q000009:adverse effects; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D062645:Percutaneous Coronary Intervention / Q000379:methods; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D013927:Thrombosis / Q000150:complications* / Q000453:epidemiology; D016896:Treatment Outcome
keywords: Non-ST-segment elevation myocardial infarction; Stent thrombosis