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Characteristics and predictors of drug-eluting stent thrombosis: results from the multicenter 'Korea Stent Thrombosis (KoST)' registry.

Authors
Park, KW; Hwang, SJ; Kwon, DA; Oh, BH; Park, YB; Chae, IH; Gwon, HC; Park, SJ; Seung, KB; Ahn, T; Yoon, JH; Jang, YS; Jeong, MH; Tahk, SJ; Kim, HS
Citation
Circulation journal : official journal of the Japanese Circulation Society, 75(7):1626-1632, 2011
Journal Title
Circulation journal : official journal of the Japanese Circulation Society
ISSN
1346-98431347-4820
Abstract
BACKGROUND: Previous studies have reported possible predictors of drug-eluting stent thrombosis (ST), but data for Asians are relatively limited. This study was performed to elucidate clinical predictors of ST in Koreans.



METHODS AND RESULTS: From May 2003 to May 2007, consecutive patients presenting with ST were enrolled from 10 cardiovascular centers in Korea. They were compared with 2,192 controls (3,223 lesions) who had received percutaneous coronary intervention with at least 6 months of follow-up without ST. On multivariate analysis, acute myocardial infarction (AMI) as initial diagnosis, drug-eluting stents (DES) in-stent restenosis (ISR), low ejection fraction (EF), small stent diameter, left anterior descending artery intervention, and young age were independent predictors of total ST. When divided into early (ST within 30 days of index procedure) and delayed ST (ST after 30 days of index procedure), low EF, small stent diameter, DES ISR and AMI as initial diagnosis were universal risks for both early and delayed ST. The time from antiplatelet agent discontinuation to ST occurrence was significantly shorter in late compared with very late ST.



CONCLUSIONS: Predictors of ST may be slightly different for early vs. delayed ST. However, low EF, small stent diameter, DES ISR lesion, and AMI as initial diagnosis were universal risk factors for both early and delayed ST cases. The relationship between antiplatelet agent discontinuation and ST occurrence seems stronger in late compared with very late ST.
MeSH terms
Aged*Angioplasty, Balloon, CoronaryCase-Control StudiesCoronary Artery Disease/physiopathology/*therapyCoronary Restenosis/diagnosis/prevention & controlDrug-Eluting Stents/*adverse effectsFemaleHumansIncidenceMaleMiddle AgedMultivariate AnalysisMyocardial Infarction/diagnosis/prevention & controlPlatelet Aggregation Inhibitors/therapeutic usePredictive Value of TestsRepublic of Korea/epidemiologyRetrospective StudiesStroke VolumeThrombosis/*diagnosis/epidemiology/*etiologyWithholding Treatment
PMID
21628837
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Journal Papers > School of Medicine / Graduate School of Medicine > Cardiology
AJOU Authors
탁, 승제
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