JACC
HOME SUBSCRIPTIONS CURRENT ISSUE PAST ISSUES CARDIOSOURCE SEARCH HELP FEEDBACK
 QUICK SEARCH:   [advanced]


     


J Am Coll Cardiol, 2002; 40:1567-1572
© 2002 by the American College of Cardiology Foundation
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Orford, J. L.
Right arrow Articles by Berger, P. B.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Orford, J. L.
Right arrow Articles by Berger, P. B.

CLINICAL STUDY: CARDIAC CATHETERIZATION AND INTERVENTION

Frequency and correlates of coronary stent thrombosis in the modern era

Analysis of a single center registry

James L. Orford, MBChB, MPHa, Ryan Lennon, MSa, Steven Melby, RNa, Panayotis Fasseas, MDa, Malcolm R. Bell, MBBS, FRACPa, Charanjit S. Rihal, MD, FACCa, David R. Holmes, MD, FACCa and Peter B. Berger, MD, FACCa,*

* Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA

Manuscript received February 18, 2002; revised manuscript received June 14, 2002, accepted July 3, 2002.

* Reprint requests and correspondence: Dr. Peter Berger, Division of Cardiovascular Diseases, Mayo Clinic, W16, 200 First Street SW, Rochester, Minnesota 55905, USA.
berger.peter{at}mayo.edu

OBJECTIVES: The study examined the frequency, correlates, and outcome of patients with stent thrombosis within 30 days of stent placement.

BACKGROUND: Patients in trials evaluating stents or dual antiplatelet therapy to prevent coronary stent thrombosis have generally had narrow inclusion criteria; the extent to which stent thrombosis rates in such trials represent current practice, particularly with the availability of newer stents, is unclear.

METHODS: We performed a retrospective analysis of the Mayo Clinic Percutaneous Coronary Intervention database and identified all patients who received at least one coronary stent and dual antiplatelet therapy (aspirin and ticlopidine or clopidogrel for two to four weeks).

RESULTS: Four thousand five hundred nine patients underwent successful coronary stent implantation and were treated with dual antiplatelet therapy between July 1, 1994, and April 30, 2000. Stent thrombosis occurred in 23 patients (0.51%; 95% confidence interval 0.32%, 0.76%) within 30 days of stent placement. Multivariate analysis using bootstrap model selection to avoid over-fitting the model indicated that only the number of stents placed was an independent correlate of stent thrombosis (odds ratio 1.80, p < 0.001). The frequency of death and frequency of nonfatal myocardial infarction (MI) among the 23 patients with stent thrombosis were 48% and 39%, respectively.

CONCLUSIONS: Stent thrombosis is even more rare in the current era than in earlier trials. Number of stents placed was an independent correlate of stent thrombosis. Most patients who suffer stent thrombosis either die or suffer MI.

Abbreviations and Acronyms
  ACT
  accelerated clotting time
  ADP
  adenosine diphosphate
  CHF
  congestive heart failure
  CI
  confidence interval
  MI
  myocardial infarction
  OR
  odds ratio
  PCI
  percutaneous coronary intervention
  TIMI
  Thrombolysis In Myocardial Infarction




This article has been cited by other articles:


Home page
The Annals of PharmacotherapyHome page
S. H Bhatt and T. H Hauser
Very Late Stent Thrombosis After Dual Antiplatelet Therapy Discontinuation in a Patient with a History of Acute Stent Thrombosis
Ann. Pharmacother., May 1, 2008; 42(5): 708 - 712.
[Abstract] [Full Text] [PDF]


Home page
CirculationHome page
B. Doyle, C. S. Rihal, C. J. O'Sullivan, R. J. Lennon, H. J. Wiste, M. Bell, J. Bresnahan, and D. R. Holmes Jr
Outcomes of Stent Thrombosis and Restenosis During Extended Follow-Up of Patients Treated With Bare-Metal Coronary Stents
Circulation, November 20, 2007; 116(21): 2391 - 2398.
[Abstract] [Full Text] [PDF]


Home page
CirculationHome page
S. Windecker and B. Meier
Late Coronary Stent Thrombosis
Circulation, October 23, 2007; 116(17): 1952 - 1965.
[Full Text] [PDF]


Home page
CirculationHome page
J. Daemen and P. W. Serruys
Drug-Eluting Stent Update 2007: Part II: Unsettled Issues
Circulation, August 21, 2007; 116(8): 961 - 968.
[Full Text] [PDF]


Home page
J Am Coll CardiolHome page
D. R. Holmes Jr, D. J. Kereiakes, W. K. Laskey, A. Colombo, S. G. Ellis, T. D. Henry, J. J. Popma, P. W.J.C. Serruys, T. Kimura, D. O. Williams, et al.
Thrombosis and Drug-Eluting Stents: An Objective Appraisal
J. Am. Coll. Cardiol., July 10, 2007; 50(2): 109 - 118.
[Abstract] [Full Text] [PDF]


Home page
J Am Coll CardiolHome page
E. S. Brilakis, S. Banerjee, and P. B. Berger
Perioperative Management of Patients With Coronary Stents
J. Am. Coll. Cardiol., June 5, 2007; 49(22): 2145 - 2150.
[Abstract] [Full Text] [PDF]


Home page
CirculationHome page
T. F. Luscher, J. Steffel, F. R. Eberli, M. Joner, G. Nakazawa, F. C. Tanner, and R. Virmani
Drug-Eluting Stent and Coronary Thrombosis: Biological Mechanisms and Clinical Implications
Circulation, February 27, 2007; 115(8): 1051 - 1058.
[Abstract] [Full Text] [PDF]


Home page
J Am Coll CardiolHome page
M. Joner, A. V. Finn, A. Farb, E. K. Mont, F. D. Kolodgie, E. Ladich, R. Kutys, K. Skorija, H. K. Gold, and R. Virmani
Pathology of Drug-Eluting Stents in Humans: Delayed Healing and Late Thrombotic Risk
J. Am. Coll. Cardiol., July 4, 2006; 48(1): 193 - 202.
[Abstract] [Full Text] [PDF]


Home page
Anesth. Analg.Home page
J. T. Murphy and B. G. Fahy
Thrombosis of Sirolimus-Eluting Coronary Stent in the Postanesthesia Care Unit
Anesth. Analg., October 1, 2005; 101(4): 971 - 973.
[Abstract] [Full Text] [PDF]


Home page
J Am Coll CardiolHome page
P. Wenaweser, J. Dorffler-Melly, K. Imboden, S. Windecker, M. Togni, B. Meier, A. Haeberli, and O. M. Hess
Stent Thrombosis Is Associated With an Impaired Response to Antiplatelet Therapy
J. Am. Coll. Cardiol., June 7, 2005; 45(11): 1748 - 1752.
[Abstract] [Full Text] [PDF]


Home page
Eur Heart JHome page
P. Wenaweser, C. Rey, F. R. Eberli, M. Togni, D. Tuller, S. Locher, A. Remondino, C. Seiler, O. M. Hess, B. Meier, et al.
Stent thrombosis following bare-metal stent implantation: success of emergency percutaneous coronary intervention and predictors of adverse outcome
Eur. Heart J., June 2, 2005; 26(12): 1180 - 1187.
[Abstract] [Full Text] [PDF]


Home page
J Am Coll CardiolHome page
K. Fujii, S. G. Carlier, G. S. Mintz, Y.-m. Yang, I. Moussa, G. Weisz, G. Dangas, R. Mehran, A. J. Lansky, E. M. Kreps, et al.
Stent underexpansion and residual reference segment stenosis are related to stent thrombosis after sirolimus-eluting stent implantation: An intravascular ultrasound study
J. Am. Coll. Cardiol., April 5, 2005; 45(7): 995 - 998.
[Abstract] [Full Text] [PDF]


Home page
J Am Coll CardiolHome page
A. T.L. Ong, A. Hoye, J. Aoki, C. A.G. van Mieghem, G. A. Rodriguez Granillo, K. Sonnenschein, E. Regar, E. P. McFadden, G. Sianos, W. J. van der Giessen, et al.
Thirty-day incidence and six-month clinical outcome of thrombotic stent occlusion after bare-metal, sirolimus, or paclitaxel stent implantation
J. Am. Coll. Cardiol., March 15, 2005; 45(6): 947 - 953.
[Abstract] [Full Text] [PDF]


Home page
J Am Coll CardiolHome page
R. Moreno, C. Fernandez, R. Hernandez, F. Alfonso, D. J. Angiolillo, M. Sabate, J. Escaned, C. Banuelos, A. Fernandez-Ortiz, and C. Macaya
Drug-eluting stent thrombosis: Results from a pooled analysis including 10 randomized studies
J. Am. Coll. Cardiol., March 15, 2005; 45(6): 954 - 959.
[Abstract] [Full Text] [PDF]


Home page
CirculationHome page
A. Chieffo, E. Bonizzoni, D. Orlic, G. Stankovic, R. Rogacka, F. Airoldi, G. W. Mikhail, M. Montorfano, I. Michev, M. Carlino, et al.
Intraprocedural Stent Thrombosis During Implantation of Sirolimus-Eluting Stents
Circulation, June 8, 2004; 109(22): 2732 - 2736.
[Abstract] [Full Text] [PDF]


Home page
CirculationHome page
A. Farb, A. P. Burke, F. D. Kolodgie, and R. Virmani
Pathological Mechanisms of Fatal Late Coronary Stent Thrombosis in Humans
Circulation, October 7, 2003; 108(14): 1701 - 1706.
[Abstract] [Full Text] [PDF]


Home page
J Am Coll CardiolHome page
T. C. Gerber, P. Fasseas, R. J. Lennon, V. U. Valeti, C. P. Wood, J. F. Breen, and P. B. Berger
Clinical safety of magnetic resonanceimaging early after coronary artery stent placement
J. Am. Coll. Cardiol., October 1, 2003; 42(7): 1295 - 1298.
[Abstract] [Full Text] [PDF]


Home page
CirculationHome page
R. Mehran, E. D. Aymong, D. T. Ashby, T. Fischell, H. Whitworth Jr, R. Siegel, W. Thomas, S. C. Wong, R. Narasimaiah, A. J. Lansky, et al.
Safety of an Aspirin-Alone Regimen After Intracoronary Stenting With a Heparin-Coated Stent: Final Results of the HOPE (HEPACOAT and an Antithrombotic Regimen of Aspirin Alone) Study
Circulation, September 2, 2003; 108(9): 1078 - 1083.
[Abstract] [Full Text] [PDF]


Home page
J Am Coll CardiolHome page
S. H. Wilson, P. Fasseas, J. L. Orford, R. J. Lennon, T. Horlocker, N. E. Charnoff, S. Melby, and P. B. Berger
Clinical outcome of patients undergoing non-cardiac surgery in the two months following coronary stenting
J. Am. Coll. Cardiol., July 16, 2003; 42(2): 234 - 240.
[Abstract] [Full Text] [PDF]


Home page
J Am Coll CardiolHome page
M. Martinez-Selles
Defining stent thrombosis: whose definition to use?
J. Am. Coll. Cardiol., April 16, 2003; 41(8): 1420 - 1420.
[Full Text] [PDF]


Home page
J Am Coll CardiolHome page
P. Berger
Reply
J. Am. Coll. Cardiol., April 16, 2003; 41(8): 1421 - 1421.
[Full Text] [PDF]




HOME SUBSCRIPTIONS CURRENT ISSUE PAST ISSUES CARDIOSOURCE SEARCH HELP FEEDBACK
Copyright © 2002 by the American College of Cardiology Foundation.