Angiographic stent thrombosis after routine use of drug-eluting stents in ST-segment elevation myocardial infarction: the importance of thrombus burden
Φόρτωση...
Ημερομηνία
Συγγραφείς
Sianos, G.
Papafaklis, M. I.
Daemen, J.
Vaina, S.
van Mieghem, C. A.
van Domburg, R. T.
Michalis, L. K.
Serruys, P. W.
Τίτλος Εφημερίδας
Περιοδικό ISSN
Τίτλος τόμου
Εκδότης
Περίληψη
Τύπος
Είδος δημοσίευσης σε συνέδριο
Είδος περιοδικού
peer-reviewed
Είδος εκπαιδευτικού υλικού
Όνομα συνεδρίου
Όνομα περιοδικού
Journal of the American College of Cardiology
Όνομα βιβλίου
Σειρά βιβλίου
Έκδοση βιβλίου
Συμπληρωματικός/δευτερεύων τίτλος
Περιγραφή
OBJECTIVES: This study sought to investigate the impact of thrombus burden on the clinical outcome and angiographic infarct-related artery stent thrombosis (IRA-ST) in patients routinely treated with drug-eluting stent (DES) implantation for ST-segment elevation myocardial infarction (STEMI). BACKGROUND: There are limited data for the safety and effectiveness of DES in STEMI. METHODS: We retrospectively analyzed 812 consecutive patients treated with DES implantation for STEMI. Intracoronary thrombus burden was angiographically estimated and categorized as large thrombus burden (LTB), defined as thrombus burden > or =2 vessel diameters, and small thrombus burden (STB) to predict clinical outcomes. Major adverse cardiac events (MACE) were defined as death, repeat myocardial infarction, and IRA reintervention. RESULTS: Mean duration of follow-up was 18.2 +/- 7.8 months. Large thrombus burden was an independent predictor of mortality (hazard ratio [HR] 1.76, p = 0.023) and MACE (HR 1.88, p = 0.001). The cumulative angiographic IRA-ST was 1.1% at 30 days and 3.2% at 2 years, and continued to augment beyond 2 years. It was significantly higher in the LTB compared with the STB group (8.2% vs. 1.3% at 2 years, respectively, p < 0.001). Significant independent predictors for IRA-ST were LTB (HR 8.73, p < 0.001), stent thrombosis at presentation (HR 6.24, p = 0.001), bifurcation stenting (HR 4.06, p = 0.002), age (HR 0.55, p = 0.003), and rheolytic thrombectomy (HR 0.11, p = 0.03). CONCLUSIONS: Large thrombus burden is an independent predictor of MACE and IRA-ST in patients treated with DES for STEMI.
Περιγραφή
Λέξεις-κλειδιά
Aged, *Angioplasty, Balloon, Coronary, Cohort Studies, Coronary Angiography, Coronary Thrombosis/complications/*radiography/therapy, Female, Graft Occlusion, Vascular/*etiology, Humans, Immunosuppressive Agents/administration & dosage, Male, Middle Aged, Myocardial Infarction/etiology/*radiography/*therapy, Predictive Value of Tests, Retrospective Studies, Severity of Illness Index, *Stents, Treatment Outcome
Θεματική κατηγορία
Παραπομπή
Σύνδεσμος
http://www.ncbi.nlm.nih.gov/pubmed/17692740
http://ac.els-cdn.com/S0735109707016695/1-s2.0-S0735109707016695-main.pdf?_tid=9a39f1cca3343ad3a8c348398e4e8637&acdnat=1333607913_e795e23b3f9efa1de2ad4cfadd88e6a8
http://ac.els-cdn.com/S0735109707016695/1-s2.0-S0735109707016695-main.pdf?_tid=9a39f1cca3343ad3a8c348398e4e8637&acdnat=1333607913_e795e23b3f9efa1de2ad4cfadd88e6a8
Γλώσσα
en
Εκδίδον τμήμα/τομέας
Όνομα επιβλέποντος
Εξεταστική επιτροπή
Γενική Περιγραφή / Σχόλια
Ίδρυμα και Σχολή/Τμήμα του υποβάλλοντος
Πανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικής