Incidence, Predictors and Clinical Outcomes of Stent Thrombosis Following Percutaneous Coronary Intervention in Contemporary Practice

Background: Stent thrombosis (ST) is an uncommon but serious complication of percutaneous coronary intervention (PCI). The reported rate of definite ST with new generation drug-eluting stents ranges from 0.5 to 1% at 30 days. We aimed to examine the incidence and outcomes of ST in a real-world setti...

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Main Authors: Batchelor, R., Dinh, D., Brennan, A., Lefkovits, J., Reid, Christopher, Duffy, S.J., Cox, N., Liew, D., Stub, D.
Format: Journal Article
Language:English
Published: ELSEVIER SCIENCE INC 2020
Subjects:
Online Access:https://research.monash.edu/en/publications/incidence-predictors-and-clinical-outcomes-of-stent-thrombosis-fo
http://hdl.handle.net/20.500.11937/93384
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author Batchelor, R.
Dinh, D.
Brennan, A.
Lefkovits, J.
Reid, Christopher
Duffy, S.J.
Cox, N.
Liew, D.
Stub, D.
author_facet Batchelor, R.
Dinh, D.
Brennan, A.
Lefkovits, J.
Reid, Christopher
Duffy, S.J.
Cox, N.
Liew, D.
Stub, D.
author_sort Batchelor, R.
building Curtin Institutional Repository
collection Online Access
description Background: Stent thrombosis (ST) is an uncommon but serious complication of percutaneous coronary intervention (PCI). The reported rate of definite ST with new generation drug-eluting stents ranges from 0.5 to 1% at 30 days. We aimed to examine the incidence and outcomes of ST in a real-world setting. Methods: The Victorian Cardiac Outcomes Registry was established in 2012 as a state-wide clinical quality registry, with all PCI capable centres contributing in 2017. Data were collected on 41,137 consecutive PCI procedures from 2013 to 2017. We describe the patient characteristics and clinical outcomes in definite and probable ST at 30 days. Results: Stent thrombosis occurred in 225 patients (0.55%). Compared to patients without ST, these patients were more likely to be female (32.0% vs 23.4%, p≤0.01) and have a history of diabetes (28.6% vs 21.9%, p=0.02). ST was more common in patients with severely reduced left ventricular ejection fraction (14.9% vs 4.6%, p<0.001) and in patients presenting with ST-elevation myocardial infarction, cardiogenic shock and cardiac arrest for their index PCI (all p<0.001). Dual antiplatelet therapy at 30 days was less frequent in patients with ST (84.8% vs 92.0%, p<0.001), while 30-day mortality was more common: 23.6% versus 2.0% (p<0.001). Conclusions: Even with contemporary stents and adjunctive medications, ST still occurs following 1 in 200 PCIs, and is associated with increased mortality at 30 days.
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spelling curtin-20.500.11937-933842023-10-25T01:10:07Z Incidence, Predictors and Clinical Outcomes of Stent Thrombosis Following Percutaneous Coronary Intervention in Contemporary Practice Batchelor, R. Dinh, D. Brennan, A. Lefkovits, J. Reid, Christopher Duffy, S.J. Cox, N. Liew, D. Stub, D. Science & Technology Life Sciences & Biomedicine Cardiac & Cardiovascular Systems Cardiovascular System & Cardiology Stent thrombosis Percutaneous coronary intervention Outcomes DRUG-ELUTING STENT BARE-METAL STENTS POOLED ANALYSIS RISK REGISTRY DISCONTINUATION IMPLANTATION METAANALYSIS FREQUENCY DISEASE Outcomes Percutaneous coronary intervention Stent thrombosis Aged Australia Coronary Angiography Coronary Thrombosis Drug-Eluting Stents Female Humans Incidence Male Percutaneous Coronary Intervention Postoperative Complications Registries Retrospective Studies Risk Factors VCOR Investigators Humans Coronary Thrombosis Postoperative Complications Coronary Angiography Registries Incidence Risk Factors Retrospective Studies Aged Australia Female Male Drug-Eluting Stents Percutaneous Coronary Intervention Background: Stent thrombosis (ST) is an uncommon but serious complication of percutaneous coronary intervention (PCI). The reported rate of definite ST with new generation drug-eluting stents ranges from 0.5 to 1% at 30 days. We aimed to examine the incidence and outcomes of ST in a real-world setting. Methods: The Victorian Cardiac Outcomes Registry was established in 2012 as a state-wide clinical quality registry, with all PCI capable centres contributing in 2017. Data were collected on 41,137 consecutive PCI procedures from 2013 to 2017. We describe the patient characteristics and clinical outcomes in definite and probable ST at 30 days. Results: Stent thrombosis occurred in 225 patients (0.55%). Compared to patients without ST, these patients were more likely to be female (32.0% vs 23.4%, p≤0.01) and have a history of diabetes (28.6% vs 21.9%, p=0.02). ST was more common in patients with severely reduced left ventricular ejection fraction (14.9% vs 4.6%, p<0.001) and in patients presenting with ST-elevation myocardial infarction, cardiogenic shock and cardiac arrest for their index PCI (all p<0.001). Dual antiplatelet therapy at 30 days was less frequent in patients with ST (84.8% vs 92.0%, p<0.001), while 30-day mortality was more common: 23.6% versus 2.0% (p<0.001). Conclusions: Even with contemporary stents and adjunctive medications, ST still occurs following 1 in 200 PCIs, and is associated with increased mortality at 30 days. 2020 Journal Article http://hdl.handle.net/20.500.11937/93384 10.1016/j.hlc.2019.10.009 English https://research.monash.edu/en/publications/incidence-predictors-and-clinical-outcomes-of-stent-thrombosis-fo http://purl.org/au-research/grants/nhmrc/1111170 http://purl.org/au-research/grants/nhmrc/1136372 ELSEVIER SCIENCE INC restricted
spellingShingle Science & Technology
Life Sciences & Biomedicine
Cardiac & Cardiovascular Systems
Cardiovascular System & Cardiology
Stent thrombosis
Percutaneous coronary intervention
Outcomes
DRUG-ELUTING STENT
BARE-METAL STENTS
POOLED ANALYSIS
RISK
REGISTRY
DISCONTINUATION
IMPLANTATION
METAANALYSIS
FREQUENCY
DISEASE
Outcomes
Percutaneous coronary intervention
Stent thrombosis
Aged
Australia
Coronary Angiography
Coronary Thrombosis
Drug-Eluting Stents
Female
Humans
Incidence
Male
Percutaneous Coronary Intervention
Postoperative Complications
Registries
Retrospective Studies
Risk Factors
VCOR Investigators
Humans
Coronary Thrombosis
Postoperative Complications
Coronary Angiography
Registries
Incidence
Risk Factors
Retrospective Studies
Aged
Australia
Female
Male
Drug-Eluting Stents
Percutaneous Coronary Intervention
Batchelor, R.
Dinh, D.
Brennan, A.
Lefkovits, J.
Reid, Christopher
Duffy, S.J.
Cox, N.
Liew, D.
Stub, D.
Incidence, Predictors and Clinical Outcomes of Stent Thrombosis Following Percutaneous Coronary Intervention in Contemporary Practice
title Incidence, Predictors and Clinical Outcomes of Stent Thrombosis Following Percutaneous Coronary Intervention in Contemporary Practice
title_full Incidence, Predictors and Clinical Outcomes of Stent Thrombosis Following Percutaneous Coronary Intervention in Contemporary Practice
title_fullStr Incidence, Predictors and Clinical Outcomes of Stent Thrombosis Following Percutaneous Coronary Intervention in Contemporary Practice
title_full_unstemmed Incidence, Predictors and Clinical Outcomes of Stent Thrombosis Following Percutaneous Coronary Intervention in Contemporary Practice
title_short Incidence, Predictors and Clinical Outcomes of Stent Thrombosis Following Percutaneous Coronary Intervention in Contemporary Practice
title_sort incidence, predictors and clinical outcomes of stent thrombosis following percutaneous coronary intervention in contemporary practice
topic Science & Technology
Life Sciences & Biomedicine
Cardiac & Cardiovascular Systems
Cardiovascular System & Cardiology
Stent thrombosis
Percutaneous coronary intervention
Outcomes
DRUG-ELUTING STENT
BARE-METAL STENTS
POOLED ANALYSIS
RISK
REGISTRY
DISCONTINUATION
IMPLANTATION
METAANALYSIS
FREQUENCY
DISEASE
Outcomes
Percutaneous coronary intervention
Stent thrombosis
Aged
Australia
Coronary Angiography
Coronary Thrombosis
Drug-Eluting Stents
Female
Humans
Incidence
Male
Percutaneous Coronary Intervention
Postoperative Complications
Registries
Retrospective Studies
Risk Factors
VCOR Investigators
Humans
Coronary Thrombosis
Postoperative Complications
Coronary Angiography
Registries
Incidence
Risk Factors
Retrospective Studies
Aged
Australia
Female
Male
Drug-Eluting Stents
Percutaneous Coronary Intervention
url https://research.monash.edu/en/publications/incidence-predictors-and-clinical-outcomes-of-stent-thrombosis-fo
https://research.monash.edu/en/publications/incidence-predictors-and-clinical-outcomes-of-stent-thrombosis-fo
https://research.monash.edu/en/publications/incidence-predictors-and-clinical-outcomes-of-stent-thrombosis-fo
http://hdl.handle.net/20.500.11937/93384