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

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dc.contributor.authorSianos, G.en
dc.contributor.authorPapafaklis, M. I.en
dc.contributor.authorDaemen, J.en
dc.contributor.authorVaina, S.en
dc.contributor.authorvan Mieghem, C. A.en
dc.contributor.authorvan Domburg, R. T.en
dc.contributor.authorMichalis, L. K.en
dc.contributor.authorSerruys, P. W.en
dc.date.accessioned2015-11-24T19:36:14Z
dc.date.available2015-11-24T19:36:14Z
dc.identifier.issn1558-3597-
dc.identifier.urihttps://olympias.lib.uoi.gr/jspui/handle/123456789/23836
dc.rightsDefault Licence-
dc.subjectAgeden
dc.subject*Angioplasty, Balloon, Coronaryen
dc.subjectCohort Studiesen
dc.subjectCoronary Angiographyen
dc.subjectCoronary Thrombosis/complications/*radiography/therapyen
dc.subjectFemaleen
dc.subjectGraft Occlusion, Vascular/*etiologyen
dc.subjectHumansen
dc.subjectImmunosuppressive Agents/administration & dosageen
dc.subjectMaleen
dc.subjectMiddle Ageden
dc.subjectMyocardial Infarction/etiology/*radiography/*therapyen
dc.subjectPredictive Value of Testsen
dc.subjectRetrospective Studiesen
dc.subjectSeverity of Illness Indexen
dc.subject*Stentsen
dc.subjectTreatment Outcomeen
dc.titleAngiographic stent thrombosis after routine use of drug-eluting stents in ST-segment elevation myocardial infarction: the importance of thrombus burdenen
heal.abstractOBJECTIVES: 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.en
heal.accesscampus-
heal.fullTextAvailabilityTRUE-
heal.identifier.primary10.1016/j.jacc.2007.04.059-
heal.identifier.secondaryhttp://www.ncbi.nlm.nih.gov/pubmed/17692740-
heal.identifier.secondaryhttp://ac.els-cdn.com/S0735109707016695/1-s2.0-S0735109707016695-main.pdf?_tid=9a39f1cca3343ad3a8c348398e4e8637&acdnat=1333607913_e795e23b3f9efa1de2ad4cfadd88e6a8-
heal.journalNameJournal of the American College of Cardiologyen
heal.journalTypepeer-reviewed-
heal.languageen-
heal.publicationDate2007-
heal.recordProviderΠανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικήςel
heal.typejournalArticle-
heal.type.elΆρθρο Περιοδικούel
heal.type.enJournal articleen

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