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Bispebjerg Hospital - en del af Københavns Universitetshospital
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Stent thrombosis is the primary cause of ST-segment elevation myocardial infarction following coronary stent implantation: a five year follow-up of the SORT OUT II study

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  • Søren Lund Kristensen
  • Anders M Galløe
  • Leif Thuesen
  • Henning Kelbæk
  • Per Thayssen
  • Ole Havndrup
  • Peter Riis Hansen
  • Niels Bligaard
  • Kari Saunamäki
  • Anders Junker
  • Jens Aarøe
  • Ulrik Abildgaard
  • Jørgen L Jeppesen
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BACKGROUND: The widespread use of coronary stents has exposed a growing population to the risk of stent thrombosis, but the importance in terms of risk of ST-segment elevation myocardial infarctions (STEMIs) remains unclear.

METHODS: We studied five years follow-up data for 2,098 all-comer patients treated with coronary stents in the randomized SORT OUT II trial (mean age 63.6 yrs. 74.8% men). Patients who following stent implantation were readmitted with STEMI were included and each patient was categorized ranging from definite- to ruled-out stent thrombosis according to the Academic Research Consortium definitions. Multivariate logistic regression was performed on selected covariates to assess odds ratios (ORs) for definite stent thrombosis.

RESULTS: 85 patients (4.1%), mean age 62.7 years, 77.1% men, were admitted with a total of 96 STEMIs, of whom 60 (62.5%) had definite stent thrombosis. Notably, definite stent thrombosis was more frequent in female than male STEMI patients (81.8% vs. 56.8%, p =  .09), and in very late STEMIs (p = 0.06). Female sex (OR 3.53 [1.01-12.59]) and clopidogrel (OR 4.43 [1.03-19.01]) was associated with increased for definite stent thrombosis, whereas age, time since stent implantation, use of statins, initial PCI urgency (STEMI [primary PCI], NSTEMI/unstable angina [subacute PCI] or stable angina [elective PCI]), and glucose-lowering agents did not seem to influence risk of stent thrombosis.

CONCLUSION: In a contemporary cohort of coronary stented patients, stent thrombosis was evident in more than 60% of subsequent STEMIs.

OriginalsprogEngelsk
TidsskriftP L o S One
Vol/bind9
Udgave nummer11
Sider (fra-til)e113399
ISSN1932-6203
DOI
StatusUdgivet - nov. 2014

ID: 44824009