Related Experiment Video
Updated: Dec 7, 2025
A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
Published on: May 14, 2013
Stent thrombosis in acute coronary syndromes: Patient-related factors and operator-related factors
Martin Kamenik1, Petr Widimsky1
1Cardiocenter, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady; Prague-Czech Republic.
Insights
Stent thrombosis (ST) in acute coronary syndromes (ACS) is linked to patient and procedural factors. Almost all ST cases involved a combination of clinical and lesion-related risks, suggesting personalized treatment strategies are needed.
Area of Science:
- Cardiology
- Interventional Cardiology
- Acute Coronary Syndromes
Background:
- Stent thrombosis (ST) is a significant complication in acute coronary syndromes (ACS).
- Understanding patient- and operator-related risk factors is crucial for prevention and management.
Purpose of the Study:
- To analyze patient- and operator-related risk factors associated with stent thrombosis (ST) in patients with acute coronary syndromes (ACS).
Main Methods:
- Retrospective analysis of coronary angiograms from 1738 consecutive ACS patients.
- Evaluation of lesion characteristics and procedural techniques by two independent observers.
- Collection of clinical and laboratory data.
Main Results:
- Stent thrombosis (ST) occurred in 1.6% of ACS patients.
- Nearly all ST cases (96%) were associated with a combination of clinical/laboratory and lesion/operator risk factors.
- Identified risk factors include renal insufficiency, type 2 diabetes, excessive alcohol consumption, STEMI, LM/LAD culprit lesions, and lack of pre-thrombosis antiplatelet therapy.
Conclusions:
- A combination of clinical and procedural risk factors is present in almost all ACS patients experiencing ST.
- Individualized treatment strategies are recommended for ACS patients at risk of ST post-percutaneous coronary intervention (PCI).
Objective:
Stent thrombosis (ST) is a common phenomenon in acute coronary syndromes (ACS) when compared to stable coronary artery disease. This study analyzed the patient- and operator-related risk factors of ST in ACS.
Methods:
Coronary angiograms of 1738 consecutive ACS patients admitted in a large tertiary center between year 2014 and 2016 were analyzed retrospectively for the presence of ST. The paired angiograms [ST in ACS during and after percutaneous coronary intervention (PCI)] of the patients were analyzed by two independent observers, with focus on lesion characteristics and procedure techniques. Clinical and laboratory data were collected.
Results:
Stent thrombosis was found in 29 (1.6%) ACS patients, with a combination of at least one clinical/laboratory risk factor and one lesion/operator risk factor identified in 28 (96%) out of the 29 ACS patients with ST. The following risk factors for ST were found: Renal insufficiency (OR=4.14, p<0.001, 95% CI=1.73-9.88), type 2 diabetes (OR=2.21, p=0.034, 95% CI=1.06-4.61), excessive alcohol consumption (OR=3.12, p=0.023, 95% CI=1.17-8.33), stent implantation for ST-elevation myocardial infarction (STEMI) (OR=2.28, p=0.029, 95% CI=1.08-4.81), left main (LM) or left anterior descending artery (LAD) as culprit lesion (OR=2.80, p=0.010, CI 95%=1.27-5.95), and absence of antiplatelet therapy prior to ST (OR=3.58, p=0.002, 95% CI=1.60-7.96). The following lesion/operator possible risk factors were identified: Bifurcation lesion (n=7; 24%), heavy coronary calcifications (n=13; 44%), in-stent restenosis with secondary plate rupture (n=6, 20%), inappropriate stent size selection (n=6, 20%), and errors in periprocedural drug administration (n=4, 14%).
Conclusion:
ST occurred in 1/62 ACS patients after PCI. A combination of clinical/laboratory and lesion/operator risk factors were present in almost all ACS patients with ST. This finding may support the search for strictly individualized strategies for the treatment of ACS patients with ST after PCI.
More Related Videos
05:41Left Anterior Descending Coronary Artery Ligation for Ischemia-Reperfusion Research: Model Improvement via Technical Modifications and Quality Control
Published on: December 16, 2022
10:28Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
Published on: March 15, 2022
Related Concept Videos
01:30Acute Coronary Syndrome I: Introduction
01:28Acute Coronary Syndrome IV: Interprofessional Care
01:26Acute Coronary Syndrome V: Nursing Management
01:19Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:26Angina IV: Management