Frequency and correlates of coronary stent thrombosis in the modern era: Analysis of a single center registry

James L. Orford, Ryan Lennon, Steven Melby, Panayotis Fasseas, Malcolm R. Bell, Charanjit Rihal, David Holmes, Peter B. Berger

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Abstract

OBJECTIVES: The study examined the frequency, correlates, and outcome of patients with stent thrombosis within 30 days of stent placement. BACKGROUND: Patients in trials evaluating stents or dual antiplatelet therapy to prevent coronary stent thrombosis have generally had narrow inclusion criteria; the extent to which stent thrombosis rates in such trials represent current practice, particularly with the availability of newer stents, is unclear. METHODS: We performed a retrospective analysis of the Mayo Clinic Percutaneous Coronary Intervention database and identified all patients who received at least one coronary stent and dual antiplatelet therapy (aspirin and ticlopidine or clopidogrel for two to four weeks). RESULTS: Four thousand five hundred nine patients underwent successful coronary stent implantation and were treated with dual antiplatelet therapy between July 1, 1994, and April 30, 2000. Stent thrombosis occurred in 23 patients (0.51%; 95% confidence interval 0.32%, 0.76%) within 30 days of stent placement. Multivariate analysis using bootstrap model selection to avoid over-fitting the model indicated that only the number of stents placed was an independent correlate of stent thrombosis (odds ratio 1.80, p < 0.001). The frequency of death and frequency of nonfatal myocardial infarction (MI) among the 23 patients with stent thrombosis were 48% and 39%, respectively. CONCLUSIONS: Stent thrombosis is even more rare in the current era than in earlier trials. Number of stents placed was an independent correlate of stent thrombosis. Most patients who suffer stent thrombosis either die or suffer MI.

Original languageEnglish (US)
Pages (from-to)1567-1572
Number of pages6
JournalJournal of the American College of Cardiology
Volume40
Issue number9
DOIs
StatePublished - Nov 6 2002
Externally publishedYes

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Coronary Thrombosis
Stents
Registries
Thrombosis
clopidogrel
Myocardial Infarction
Ticlopidine

ASJC Scopus subject areas

  • Nursing(all)

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Frequency and correlates of coronary stent thrombosis in the modern era : Analysis of a single center registry. / Orford, James L.; Lennon, Ryan; Melby, Steven; Fasseas, Panayotis; Bell, Malcolm R.; Rihal, Charanjit; Holmes, David; Berger, Peter B.

In: Journal of the American College of Cardiology, Vol. 40, No. 9, 06.11.2002, p. 1567-1572.

Research output: Contribution to journalArticle

Orford, James L. ; Lennon, Ryan ; Melby, Steven ; Fasseas, Panayotis ; Bell, Malcolm R. ; Rihal, Charanjit ; Holmes, David ; Berger, Peter B. / Frequency and correlates of coronary stent thrombosis in the modern era : Analysis of a single center registry. In: Journal of the American College of Cardiology. 2002 ; Vol. 40, No. 9. pp. 1567-1572.
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AU - Bell, Malcolm R.

AU - Rihal, Charanjit

AU - Holmes, David

AU - Berger, Peter B.

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N2 - OBJECTIVES: The study examined the frequency, correlates, and outcome of patients with stent thrombosis within 30 days of stent placement. BACKGROUND: Patients in trials evaluating stents or dual antiplatelet therapy to prevent coronary stent thrombosis have generally had narrow inclusion criteria; the extent to which stent thrombosis rates in such trials represent current practice, particularly with the availability of newer stents, is unclear. METHODS: We performed a retrospective analysis of the Mayo Clinic Percutaneous Coronary Intervention database and identified all patients who received at least one coronary stent and dual antiplatelet therapy (aspirin and ticlopidine or clopidogrel for two to four weeks). RESULTS: Four thousand five hundred nine patients underwent successful coronary stent implantation and were treated with dual antiplatelet therapy between July 1, 1994, and April 30, 2000. Stent thrombosis occurred in 23 patients (0.51%; 95% confidence interval 0.32%, 0.76%) within 30 days of stent placement. Multivariate analysis using bootstrap model selection to avoid over-fitting the model indicated that only the number of stents placed was an independent correlate of stent thrombosis (odds ratio 1.80, p < 0.001). The frequency of death and frequency of nonfatal myocardial infarction (MI) among the 23 patients with stent thrombosis were 48% and 39%, respectively. CONCLUSIONS: Stent thrombosis is even more rare in the current era than in earlier trials. Number of stents placed was an independent correlate of stent thrombosis. Most patients who suffer stent thrombosis either die or suffer MI.

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