Angiographic stent thrombosis after routine use of drug-eluting stents in ST-segment elevation myocardial infarction: the importance of thrombus burden
Φόρτωση...
Ημερομηνία
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