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Published on: May 14, 2013
Coronary stent thrombosis in bare metal stents
Waqar H Ahmed1, Khaled F Al-Shaibi
1King Fahd Armed Forces Hospital, PO Box 9862, Jeddah 21159, Kingdom of Saudi Arabia. waqar@post.harvard.edu
Insights
Coronary stent thrombosis occurs in about 1% of patients. Longer stent length in the left anterior descending artery after myocardial infarction may increase the risk of stent thrombosis.
Area of Science:
- Cardiology
- Interventional Cardiology
- Biomedical Engineering
Background:
- Coronary stent thrombosis incidence has decreased due to improved techniques and drugs.
- Clinical trials may not reflect real-world practice with complex patients.
- Bare metal stents are widely used in coronary interventions.
Purpose of the Study:
- To examine the frequency, predisposing factors, and outcomes of stent thrombosis.
- To assess stent thrombosis in unselected patients receiving bare metal stents.
- To identify patient and procedural characteristics associated with stent thrombosis.
Main Methods:
- Prospective database of all patients undergoing stent implantation.
- Review of stent thrombosis incidence in patients with at least 6 months follow-up.
- Analysis of clinical data for unselected patient cohorts.
Main Results:
- Stent thrombosis occurred in 9 (0.8%) of 1140 patients.
- Most cases (78%) presented within 30 days post-procedure.
- All cases involved the left anterior descending artery, with 89% having recent anterior myocardial infarction and a mean stent length of 25 mm.
Conclusions:
- The incidence of stent thrombosis is approximately 1% in the current interventional era.
- Longer stent length in the left anterior descending artery after recent myocardial infarction is associated with stent thrombosis.
- Findings highlight specific risk factors for stent thrombosis in real-world practice.
Objective:
The incidence of coronary stent thrombosis has reduced with improved techniques and drugs. Nevertheless, clinical trials may not reflect real world practice due to the selective inclusion criteria, regional variations and more complex patients treated in day-to-day practice. We examined the frequency, predisposing factors and outcome of stent thrombosis in unselected patients undergoing bare metal stents.
Methods:
All patients undergoing stent implantation are entered into a prospective database. We reviewed the incidence of stent thrombosis in our database for all patients with at least 6 months of follow up.
Results:
From December 1996 through to December 2002, 1140 consecutive patients underwent a coronary stenting. Stent thrombosis occurred in 9 (0.8%) patients; 7 (78%) presented within 30 days of the procedure, while 2 had late stent thrombosis occurring after 30 days. The vessel was left anterior descending artery in all, 8 (89%) had a recent anterior myocardial infarction prior to the intervention and the mean stent length was 25 mm.
Conclusion:
The incidence of stent thrombosis is approximately 1% in the current era of intervention. Longer stent length in the left anterior descending artery following a recent myocardial infarction, seems to be associated with stent thrombosis.
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