Back to Search
Start Over
Predictors and Implications of Stent Thrombosis in Non–ST-Segment Elevation Acute Coronary Syndromes
- Source :
- Circulation: Cardiovascular Interventions. 4:577-584
- Publication Year :
- 2011
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2011.
-
Abstract
- Background— The frequency, predictors, and consequences of stent thrombosis (ST) in patients with non–ST-segment elevation acute coronary syndromes (NSTE-ACS) have been incompletely studied. We sought to investigate the incidence, predictors, and clinical implications of ST occurring within 1 year after percutaneous coronary intervention in patients with NSTE-ACS. Methods and Results— The Acute Catheterization and Urgent Intervention Triage StrategY (ACUITY) trial was a large-scale, prospective, randomized trial of antithrombotic regimens in patients with NSTE-ACS. The present analysis includes 7162 patients in whom stents were implanted. At 1 year, definite/probable ST occurred in 146 patients (2.2%), including 94 definite and 52 probable events. There were 100 episodes (1.4%) of early ST (within the first 30 days) and 46 episodes (0.8%) of late ST (between 30 days and 1 year). The incidence of ST within 1 year was similar in patients treated with drug-eluting stents or bare metal stents (hazard ratio, 0.86; 95% confidence interval, 0.62–1.20; P =0.38) and was independent of procedural antithrombotic treatment. Patients with ST compared with those without ST had strikingly higher 1-year rates of cardiac mortality (32.4% versus 2.9%, P P P Conclusions— Compared with elective stent implantation, ST occurs with increased frequency in the first year after stent implantation in patients with NSTE-ACS, especially within the first 30 days, and is associated with marked increases in cardiac mortality and adverse events. Insulin-treated diabetes, number of diseased vessels, and dynamic ST-segment changes were independent predictors of 1-year ST in NSTE-ACS. Clinical Trial Registration— URL: http://www.clinicaltrials.gov . Unique identifier: NCT00093158.
- Subjects :
- Male
medicine.medical_specialty
medicine.medical_treatment
Comorbidity
law.invention
Electrocardiography
Fibrinolytic Agents
Randomized controlled trial
Predictive Value of Tests
Risk Factors
law
Internal medicine
Antithrombotic
Prevalence
medicine
Humans
ST segment
Prospective Studies
Acute Coronary Syndrome
Angioplasty, Balloon, Coronary
Aged
business.industry
Coronary Thrombosis
Incidence (epidemiology)
Hazard ratio
Percutaneous coronary intervention
Drug-Eluting Stents
Middle Aged
Coronary Vessels
Triage
Surgery
Diabetes Mellitus, Type 1
Metals
Drug-eluting stent
Cardiology
Female
Stents
Cardiology and Cardiovascular Medicine
business
Follow-Up Studies
Subjects
Details
- ISSN :
- 19417632 and 19417640
- Volume :
- 4
- Database :
- OpenAIRE
- Journal :
- Circulation: Cardiovascular Interventions
- Accession number :
- edsair.doi.dedup.....e69711c3791efd642c1feb135571fd19