Frequency of and Risk Factors for Stent Thrombosis After Drug-Eluting Stent Implantation During Long-Term Follow-Up

Duk Woo Park, Seong Wook Park, Kyoung Ha Park, Bong Ki Lee, Young Hak Kim, Cheol Whan Lee, Myeongki Hong, Jae Joong Kim, Seung Jung Park

Research output: Contribution to journalArticle

419 Citations (Scopus)

Abstract

Despite concerns regarding the long-term safety of drug-eluting stent (DES) implantation because of late-onset stent thrombosis, the actual incidence of stent thrombosis after 1 year is unknown. We investigated the incidence, risk factors, and association of antiplatelet therapy interruption for the development of stent thrombosis after DES implantation during long-term follow-up. A total of 1,911 consecutive patients with DES implantation were enrolled (sirolimus-eluting stents in 1,545 patients, 2,045 lesions; paclitaxel-eluting stents in 366 patients, 563 lesions). During long-term follow-up (median 19.4 months, interquartile range 15.3 to 24.3), 15 patients (0.8%, 95% confidence interval 0.5% to 1.3%) developed stent thrombosis within 6 hours to 20.4 months. Eleven patients (0.6%, 95% confidence interval 0.3% to 1.0%) had late thrombosis (median 6.1 months). The incidence of stent thrombosis was 3.3% (4 of 121 patients) in patients with complete interruption of antiplatelet therapy (vs 0.6% in those without, p = 0.004) and 7.8% (5 of 64 patients) with premature interruption of aspirin or clopidogrel, or both (vs 0.5% in those without, p <0.001). Independent predictors of stent thrombosis were premature antiplatelet therapy interruption, primary stenting in acute myocardial infarction, and total stent length. Stent thrombosis also developed while patients were on dual antiplatelet therapy (all patients with acute/subacute stent thrombosis and 36% of those with late stent thrombosis; 47% of total with stent thrombosis). In conclusion, stent thrombosis occurred in 0.8% after DES implantation during long-term follow-up. The incidence of late stent thrombosis was 0.6%, similar to that for bare metal stents. The predictors of stent thrombosis were premature antiplatelet therapy interruption, primary stenting in acute myocardial infarction, and total stent length.

Original languageEnglish
Pages (from-to)352-356
Number of pages5
JournalAmerican Journal of Cardiology
Volume98
Issue number3
DOIs
Publication statusPublished - 2006 Aug 1

Fingerprint

Drug-Eluting Stents
Stents
Thrombosis
clopidogrel
Incidence
Myocardial Infarction
Confidence Intervals
Therapeutics

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Park, Duk Woo ; Park, Seong Wook ; Park, Kyoung Ha ; Lee, Bong Ki ; Kim, Young Hak ; Lee, Cheol Whan ; Hong, Myeongki ; Kim, Jae Joong ; Park, Seung Jung. / Frequency of and Risk Factors for Stent Thrombosis After Drug-Eluting Stent Implantation During Long-Term Follow-Up. In: American Journal of Cardiology. 2006 ; Vol. 98, No. 3. pp. 352-356.
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title = "Frequency of and Risk Factors for Stent Thrombosis After Drug-Eluting Stent Implantation During Long-Term Follow-Up",
abstract = "Despite concerns regarding the long-term safety of drug-eluting stent (DES) implantation because of late-onset stent thrombosis, the actual incidence of stent thrombosis after 1 year is unknown. We investigated the incidence, risk factors, and association of antiplatelet therapy interruption for the development of stent thrombosis after DES implantation during long-term follow-up. A total of 1,911 consecutive patients with DES implantation were enrolled (sirolimus-eluting stents in 1,545 patients, 2,045 lesions; paclitaxel-eluting stents in 366 patients, 563 lesions). During long-term follow-up (median 19.4 months, interquartile range 15.3 to 24.3), 15 patients (0.8{\%}, 95{\%} confidence interval 0.5{\%} to 1.3{\%}) developed stent thrombosis within 6 hours to 20.4 months. Eleven patients (0.6{\%}, 95{\%} confidence interval 0.3{\%} to 1.0{\%}) had late thrombosis (median 6.1 months). The incidence of stent thrombosis was 3.3{\%} (4 of 121 patients) in patients with complete interruption of antiplatelet therapy (vs 0.6{\%} in those without, p = 0.004) and 7.8{\%} (5 of 64 patients) with premature interruption of aspirin or clopidogrel, or both (vs 0.5{\%} in those without, p <0.001). Independent predictors of stent thrombosis were premature antiplatelet therapy interruption, primary stenting in acute myocardial infarction, and total stent length. Stent thrombosis also developed while patients were on dual antiplatelet therapy (all patients with acute/subacute stent thrombosis and 36{\%} of those with late stent thrombosis; 47{\%} of total with stent thrombosis). In conclusion, stent thrombosis occurred in 0.8{\%} after DES implantation during long-term follow-up. The incidence of late stent thrombosis was 0.6{\%}, similar to that for bare metal stents. The predictors of stent thrombosis were premature antiplatelet therapy interruption, primary stenting in acute myocardial infarction, and total stent length.",
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Frequency of and Risk Factors for Stent Thrombosis After Drug-Eluting Stent Implantation During Long-Term Follow-Up. / Park, Duk Woo; Park, Seong Wook; Park, Kyoung Ha; Lee, Bong Ki; Kim, Young Hak; Lee, Cheol Whan; Hong, Myeongki; Kim, Jae Joong; Park, Seung Jung.

In: American Journal of Cardiology, Vol. 98, No. 3, 01.08.2006, p. 352-356.

Research output: Contribution to journalArticle

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T1 - Frequency of and Risk Factors for Stent Thrombosis After Drug-Eluting Stent Implantation During Long-Term Follow-Up

AU - Park, Duk Woo

AU - Park, Seong Wook

AU - Park, Kyoung Ha

AU - Lee, Bong Ki

AU - Kim, Young Hak

AU - Lee, Cheol Whan

AU - Hong, Myeongki

AU - Kim, Jae Joong

AU - Park, Seung Jung

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AB - Despite concerns regarding the long-term safety of drug-eluting stent (DES) implantation because of late-onset stent thrombosis, the actual incidence of stent thrombosis after 1 year is unknown. We investigated the incidence, risk factors, and association of antiplatelet therapy interruption for the development of stent thrombosis after DES implantation during long-term follow-up. A total of 1,911 consecutive patients with DES implantation were enrolled (sirolimus-eluting stents in 1,545 patients, 2,045 lesions; paclitaxel-eluting stents in 366 patients, 563 lesions). During long-term follow-up (median 19.4 months, interquartile range 15.3 to 24.3), 15 patients (0.8%, 95% confidence interval 0.5% to 1.3%) developed stent thrombosis within 6 hours to 20.4 months. Eleven patients (0.6%, 95% confidence interval 0.3% to 1.0%) had late thrombosis (median 6.1 months). The incidence of stent thrombosis was 3.3% (4 of 121 patients) in patients with complete interruption of antiplatelet therapy (vs 0.6% in those without, p = 0.004) and 7.8% (5 of 64 patients) with premature interruption of aspirin or clopidogrel, or both (vs 0.5% in those without, p <0.001). Independent predictors of stent thrombosis were premature antiplatelet therapy interruption, primary stenting in acute myocardial infarction, and total stent length. Stent thrombosis also developed while patients were on dual antiplatelet therapy (all patients with acute/subacute stent thrombosis and 36% of those with late stent thrombosis; 47% of total with stent thrombosis). In conclusion, stent thrombosis occurred in 0.8% after DES implantation during long-term follow-up. The incidence of late stent thrombosis was 0.6%, similar to that for bare metal stents. The predictors of stent thrombosis were premature antiplatelet therapy interruption, primary stenting in acute myocardial infarction, and total stent length.

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