Incidence, predictors, and long term clinical outcome of angiographic definite stent thrombosis in real world scenario - A prospective cohort study.

BACKGROUND

The occurrence of stent thrombosis (ST) in real world scenario is far different from that mentioned in the literature. Our study identifies the various parameters of ST.

METHODS

This is a prospective observational-cohort study where-in consecutive patients who received successful percutaneous transluminal angioplasty (PTCA) over the study period of 1-year was included and were followed for 1-year from the primary procedure.

RESULTS

The overall incidence of definite ST was 1.4% and 1.7% at 30 days and 1 year respectively. The most common mode of presentation of ST was ST-elevation myocardial infarction (82.6%). The history of prior PTCA, multi-vessel disease, emergent PTCA, acute coronary syndrome and type B2/C lesions were found to be the independent predictors for definite ST. The incidence of late ST was significantly higher with bare metal stent (BMS) than drug-eluting stent (DES) (OR-2.4, 95% CI:1.3-4.5). At mean follow-up of 13.9 months after ST, the overall mortality was 36.9%. The independent predictors of mortality after ST were post-PTCA thrombolysis in myocardial infarction (TIMI) flow grade < 3, and cardiogenic shock at the time of presentation.

CONCLUSION

The overall incidence of definite ST is high in the real world scenario and the DES fared better than BMS. ST carries a bad prognosis especially so if the patients present in cardiogenic shock, or unable to achieve TIMI-3 flow after PTCA.