Influence of coronary thrombus on outcome of percutaneous coronary angioplasty in the current era (The Mayo Clinic Experience)

Mandeep Singh, Peter B. Berger, Henry H. Ting, Charanjit Rihal, Stephanie H. Wilson, Ryan J. Lennon, Guy S. Reeder, John F. Bresnahan, David Holmes

Research output: Contribution to journalArticle

77 Citations (Scopus)

Abstract

Earlier studies documented an increased risk of percutaneous coronary intervention (PCI) in patients with angiographic evidence of thrombus. With newer antiplatelet agents and stents, it is not known whether thrombus is a risk factor after PCI. This study examines whether outcome of PCI in patients with thrombus has improved, and whether thrombus is associated with adverse outcome after PCI in the current era. This single-institution retrospective analysis of PCI in 7,184 patients was divided into 2 periods: group I, 1990 to 1995 (n = 3,640), and group II, 1996 to 1999 (n = 3,544). The groups were subdivided according to the presence or absence of angiographic thrombus before PCI. We compared the outcome of PCI for patients with and without thrombus in group II. A comparison was made in the 2 groups in patients with angiographic thrombus. Procedural success improved in group II compared with group I patients with thrombus (93% vs 88%, p <0.001). There was significant reduction in abrupt closure in the recent era in patients with thrombus (4% vs 7%, p = 0.01). In group II, procedural success remained lower in patients with (93% vs 96%) than without thrombus (p <0.001). After adjusting for the significant univariate characteristics of group II patients, thrombus remained an independent predictor of Q-wave infarction (odds ratio 3.78; 95% confidence interval [CI], 1.8 to 8.0; p <0.0013) and the composite end point of death, Q-wave infarction, and emergency bypass surgery (odds ratio 2.37; 95% CI 1.4 to 4.1; p = 0.002). There was a trend toward increased in-hospital death among patients with thrombus (odds ratio 2.06; 95% CI 0.9 to 4.8; p = 0.09). The 1-year outcome after successful PCI was similar for those with and without thrombus. Despite improvement in the outcome of patients with thrombus undergoing PCI in recent years, thrombus is still an independent predictor of adverse in-hospital outcomes after PCI.

Original languageEnglish (US)
Pages (from-to)1091-1096
Number of pages6
JournalAmerican Journal of Cardiology
Volume88
Issue number10
DOIs
StatePublished - Nov 15 2001

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Angioplasty
Thrombosis
Percutaneous Coronary Intervention
Odds Ratio
Confidence Intervals
Infarction
Platelet Aggregation Inhibitors
Stents
Emergencies

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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Influence of coronary thrombus on outcome of percutaneous coronary angioplasty in the current era (The Mayo Clinic Experience). / Singh, Mandeep; Berger, Peter B.; Ting, Henry H.; Rihal, Charanjit; Wilson, Stephanie H.; Lennon, Ryan J.; Reeder, Guy S.; Bresnahan, John F.; Holmes, David.

In: American Journal of Cardiology, Vol. 88, No. 10, 15.11.2001, p. 1091-1096.

Research output: Contribution to journalArticle

Singh, Mandeep ; Berger, Peter B. ; Ting, Henry H. ; Rihal, Charanjit ; Wilson, Stephanie H. ; Lennon, Ryan J. ; Reeder, Guy S. ; Bresnahan, John F. ; Holmes, David. / Influence of coronary thrombus on outcome of percutaneous coronary angioplasty in the current era (The Mayo Clinic Experience). In: American Journal of Cardiology. 2001 ; Vol. 88, No. 10. pp. 1091-1096.
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