title: Clinical characteristics, angiographic findings, and one-year outcome of 101 consecutive stent thrombosis cases in British Columbia.
abstract: BACKGROUND
  Stent thrombosis (ST) is rare, but is associated with significant morbidity and mortality.
  
  
  METHODS
  We analyzed data from the British Columbia (BC) Registry from April 2011-January 2012.
  
  
  RESULTS
  101 ST cases were reported and verified. Based on timing, ST was considered early (≤30days) in 35.6%, late (>30days-1year) in 17.8% and very late (>1year) in 46.5%. The majority (68.5%) presented with STEMI, and the remaining with non-STEMI (31.5%). Most vessels were functionally occluded (TIM1 flow grade ≤1 in 67.1%). Thrombus burden was high (TIMI thrombus grade ≥4 in 77.2%). Aspiration thrombectomy was performed in 41% of cases. New stents were implanted in 62.4% cases. Intra-coronary imaging was low (11%). At the original stent implantation, STEMI was the clinical presentation in 39.6%, the lesion was complex in 62.1%, and thrombus was visualized in 23.0%. Prognosis after ST was unfavorable with high mortality (11.9% at 30days and 16.8% at one year), and further revascularization (5.0% repeat PCI and 6.9% coronary artery bypass graft surgery). Early ST was associated with worse clinical outcome compared to late/very late ST: 30-day mortality at 22.2% versus 6.2% (p=0.02), and 1-year mortality at 27.8% versus 10.8% (p=0.05).
  
  
  CONCLUSIONS
  In this prospective registry from BC, all ST presented with myocardial infarction, and the majority was treated with emergency PCI. Additional stents were commonly implanted with infrequent use of intracoronary imaging. Mortality rate was higher for early ST in comparison with late/very late ST. A comprehensive approach should be developed to treat this difficult complication.
authors.affiliation: Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia.
authors.forename: Mathieu
authors.initials: M
authors.lastname: Lempereur
authors.affiliation: Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia.
authors.forename: Nigussie
authors.initials: N
authors.lastname: Bogale
authors.affiliation: Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia.
authors.forename: Peter
authors.initials: P
authors.lastname: Fahmy
authors.affiliation: Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia.
authors.forename: Imran
authors.initials: I
authors.lastname: Shiekh
authors.affiliation: Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Starovoytov
authors.affiliation: St. Paul's Hospital, Vancouver, British Columbia.
authors.forename: Eve
authors.initials: E
authors.lastname: Aymong
authors.affiliation: St. Paul's Hospital, Vancouver, British Columbia.
authors.forename: Robert
authors.initials: R
authors.lastname: Boone
authors.affiliation: Royal Jubilee Hospital, Victoria, British Columbia.
authors.forename: Simon
authors.initials: S
authors.lastname: Robinson
authors.affiliation: Royal Columbian Hospital, New Westminster, British Columbia.
authors.forename: Jahangir
authors.initials: J
authors.lastname: Charania
authors.affiliation: Kelowna General Hospital, Kelowna, British Columbia.
authors.forename: Richard
authors.initials: R
authors.lastname: Townley
authors.affiliation: St. Paul's Hospital, Vancouver, British Columbia.
authors.forename: Christopher
authors.initials: C
authors.lastname: Thompson
authors.affiliation: Cardiac Services BC, Vancouver, British Columbia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Kmetic
authors.affiliation: Cardiac Services BC, Vancouver, British Columbia.
authors.forename: Lillian
authors.initials: L
authors.lastname: Ding
authors.affiliation: Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia. Electronic address: a.fung@ubc.ca.
authors.forename: Anthony
authors.initials: A
authors.lastname: Fung
mesh_terms: D000368:Aged; D001955:British Columbia; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D003328:Coronary Thrombosis / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D003430:Cross-Sectional Studies; D004638:Emergency Treatment; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects* / Q000295:instrumentation* / Q000401:mortality; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012042:Registries; D019233:Retreatment; D012307:Risk Factors; D015607:Stents; D017131:Thrombectomy; D013997:Time Factors; D016896:Treatment Outcome
keywords: Acute coronary syndrome; Outcomes; PCI; Stent thrombosis