Frequency of Coronary Arterial Late Angiographic Stent Thrombosis (LAST) in the First Six Months: Outcomes With Drug-Eluting Stents Versus Bare Metal Stents

Duk Woo Park, Seong Wook Park, Seung Whan Lee, Young Hak Kim, Cheol Whan Lee, Myeong Ki Hong, Jae Joong Kim, Seung Jung Park

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Concerns have been raised about the long-term safety of drug-eluting stent (DES) implantation due to late angiographic stent thrombosis (LAST). We investigated the incidence and 6-month clinical and angiographic outcomes of LAST after DES versus bare metal stent (BMS) implantation. This study comprised 6,551 patients treated with BMSs (n = 4,104) or DESs (n = 2,447). LAST was defined as angiographically proved stent thrombotic occlusion with acute ischemic symptoms >30 days after stenting. Major adverse cardiac events were defined as death, Q-wave myocardial infarction, and target lesion revascularization. Patients treated with DESs had a significantly higher risk profile than did patients treated with BMSs. There were 8 cases (0.33%) of LAST in the DES group and 7 (0.17%) in the BMS group, showing similar event rates after risk adjustment (adjusted hazard ratio 1.2, 95% confidence interval 0.1 to 18.4, p = 0.9). Four patients with LAST treated with DESs (50%) and 1 treated with BMSs (14%) were associated with discontinuation of antiplatelet therapy. Two cases (25%) of LAST with DESs occurred in patients on aspirin monotherapy and another 2 cases (25%) occurred in patients on dual antiplatelet therapy. There was no case of in-hospital death associated with LAST events. At 6-month follow-up after LAST events, major adverse cardiac events occurred in only 3 patients (43%) in the BMS group. In conclusion, the incidence of LAST was similar after DES and BMS implantations. LAST treated with DESs was associated with antiplatelet therapy discontinuation in a significant number of patients, and LAST events also developed on dual antiplatelet therapy. Patients with LAST and DESs showed favorable outcomes during follow-up.

Original languageEnglish
Pages (from-to)774-778
Number of pages5
JournalAmerican Journal of Cardiology
Volume99
Issue number6
DOIs
Publication statusPublished - 2007 Mar 15

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Drug-Eluting Stents
Stents
Thrombosis
Metals
Risk Adjustment
Incidence
Therapeutics

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Park, Duk Woo ; Park, Seong Wook ; Lee, Seung Whan ; Kim, Young Hak ; Lee, Cheol Whan ; Hong, Myeong Ki ; Kim, Jae Joong ; Park, Seung Jung. / Frequency of Coronary Arterial Late Angiographic Stent Thrombosis (LAST) in the First Six Months : Outcomes With Drug-Eluting Stents Versus Bare Metal Stents. In: American Journal of Cardiology. 2007 ; Vol. 99, No. 6. pp. 774-778.
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title = "Frequency of Coronary Arterial Late Angiographic Stent Thrombosis (LAST) in the First Six Months: Outcomes With Drug-Eluting Stents Versus Bare Metal Stents",
abstract = "Concerns have been raised about the long-term safety of drug-eluting stent (DES) implantation due to late angiographic stent thrombosis (LAST). We investigated the incidence and 6-month clinical and angiographic outcomes of LAST after DES versus bare metal stent (BMS) implantation. This study comprised 6,551 patients treated with BMSs (n = 4,104) or DESs (n = 2,447). LAST was defined as angiographically proved stent thrombotic occlusion with acute ischemic symptoms >30 days after stenting. Major adverse cardiac events were defined as death, Q-wave myocardial infarction, and target lesion revascularization. Patients treated with DESs had a significantly higher risk profile than did patients treated with BMSs. There were 8 cases (0.33{\%}) of LAST in the DES group and 7 (0.17{\%}) in the BMS group, showing similar event rates after risk adjustment (adjusted hazard ratio 1.2, 95{\%} confidence interval 0.1 to 18.4, p = 0.9). Four patients with LAST treated with DESs (50{\%}) and 1 treated with BMSs (14{\%}) were associated with discontinuation of antiplatelet therapy. Two cases (25{\%}) of LAST with DESs occurred in patients on aspirin monotherapy and another 2 cases (25{\%}) occurred in patients on dual antiplatelet therapy. There was no case of in-hospital death associated with LAST events. At 6-month follow-up after LAST events, major adverse cardiac events occurred in only 3 patients (43{\%}) in the BMS group. In conclusion, the incidence of LAST was similar after DES and BMS implantations. LAST treated with DESs was associated with antiplatelet therapy discontinuation in a significant number of patients, and LAST events also developed on dual antiplatelet therapy. Patients with LAST and DESs showed favorable outcomes during follow-up.",
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Frequency of Coronary Arterial Late Angiographic Stent Thrombosis (LAST) in the First Six Months : Outcomes With Drug-Eluting Stents Versus Bare Metal Stents. / Park, Duk Woo; Park, Seong Wook; Lee, Seung Whan; Kim, Young Hak; Lee, Cheol Whan; Hong, Myeong Ki; Kim, Jae Joong; Park, Seung Jung.

In: American Journal of Cardiology, Vol. 99, No. 6, 15.03.2007, p. 774-778.

Research output: Contribution to journalArticle

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AU - Park, Duk Woo

AU - Park, Seong Wook

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AU - Park, Seung Jung

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N2 - Concerns have been raised about the long-term safety of drug-eluting stent (DES) implantation due to late angiographic stent thrombosis (LAST). We investigated the incidence and 6-month clinical and angiographic outcomes of LAST after DES versus bare metal stent (BMS) implantation. This study comprised 6,551 patients treated with BMSs (n = 4,104) or DESs (n = 2,447). LAST was defined as angiographically proved stent thrombotic occlusion with acute ischemic symptoms >30 days after stenting. Major adverse cardiac events were defined as death, Q-wave myocardial infarction, and target lesion revascularization. Patients treated with DESs had a significantly higher risk profile than did patients treated with BMSs. There were 8 cases (0.33%) of LAST in the DES group and 7 (0.17%) in the BMS group, showing similar event rates after risk adjustment (adjusted hazard ratio 1.2, 95% confidence interval 0.1 to 18.4, p = 0.9). Four patients with LAST treated with DESs (50%) and 1 treated with BMSs (14%) were associated with discontinuation of antiplatelet therapy. Two cases (25%) of LAST with DESs occurred in patients on aspirin monotherapy and another 2 cases (25%) occurred in patients on dual antiplatelet therapy. There was no case of in-hospital death associated with LAST events. At 6-month follow-up after LAST events, major adverse cardiac events occurred in only 3 patients (43%) in the BMS group. In conclusion, the incidence of LAST was similar after DES and BMS implantations. LAST treated with DESs was associated with antiplatelet therapy discontinuation in a significant number of patients, and LAST events also developed on dual antiplatelet therapy. Patients with LAST and DESs showed favorable outcomes during follow-up.

AB - Concerns have been raised about the long-term safety of drug-eluting stent (DES) implantation due to late angiographic stent thrombosis (LAST). We investigated the incidence and 6-month clinical and angiographic outcomes of LAST after DES versus bare metal stent (BMS) implantation. This study comprised 6,551 patients treated with BMSs (n = 4,104) or DESs (n = 2,447). LAST was defined as angiographically proved stent thrombotic occlusion with acute ischemic symptoms >30 days after stenting. Major adverse cardiac events were defined as death, Q-wave myocardial infarction, and target lesion revascularization. Patients treated with DESs had a significantly higher risk profile than did patients treated with BMSs. There were 8 cases (0.33%) of LAST in the DES group and 7 (0.17%) in the BMS group, showing similar event rates after risk adjustment (adjusted hazard ratio 1.2, 95% confidence interval 0.1 to 18.4, p = 0.9). Four patients with LAST treated with DESs (50%) and 1 treated with BMSs (14%) were associated with discontinuation of antiplatelet therapy. Two cases (25%) of LAST with DESs occurred in patients on aspirin monotherapy and another 2 cases (25%) occurred in patients on dual antiplatelet therapy. There was no case of in-hospital death associated with LAST events. At 6-month follow-up after LAST events, major adverse cardiac events occurred in only 3 patients (43%) in the BMS group. In conclusion, the incidence of LAST was similar after DES and BMS implantations. LAST treated with DESs was associated with antiplatelet therapy discontinuation in a significant number of patients, and LAST events also developed on dual antiplatelet therapy. Patients with LAST and DESs showed favorable outcomes during follow-up.

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