Characteristics and predictors of drug-eluting stent thrombosis: Results from the multicenter Korea stent thrombosis (KoST) registry

Kyung Woo Park, Seok Jae Hwang, Dong A. Kwon, Byung Hee Oh, Young Bae Park, In Ho Chae, Hyeon Cheol Gwon, Seung Jung Park, Ki Bae Seung, Taehoon Ahn, Jung Han Yoon, Yang Soo Jang, Myung Ho Jeong, Seung Jea Tahk, Hyo Soo Kim

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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.

Original languageEnglish
Pages (from-to)1626-1632
Number of pages7
JournalCirculation Journal
Volume75
Issue number7
DOIs
Publication statusPublished - 2011 Jul 1

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All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Park, K. W., Hwang, S. J., Kwon, D. A., Oh, B. H., Park, Y. B., Chae, I. H., Gwon, H. C., Park, S. J., Seung, K. B., Ahn, T., Yoon, J. H., Jang, Y. S., Jeong, M. H., Tahk, S. J., & Kim, H. S. (2011). Characteristics and predictors of drug-eluting stent thrombosis: Results from the multicenter Korea stent thrombosis (KoST) registry. Circulation Journal, 75(7), 1626-1632. https://doi.org/10.1253/circj.CJ-10-1160