Predictors of stent thrombosis after primary stenting for acute myocardial infarction

Silva, Jose A., Nunez, Eduardo, White, Christopher J., Collins, Tyrone J., Jenkins, J. Stephen, Zhang, Shuyang, Jain, Suresh P. and Ramee, Stephen R. (1999) Predictors of stent thrombosis after primary stenting for acute myocardial infarction. Catheterization and Cardiovascular Interventions, 47 4: 415-422. doi:10.1002/(SICI)1522-726X(199908)47:4<415::AID-CCD8>3.0.CO;2-I

Author Silva, Jose A.
Nunez, Eduardo
White, Christopher J.
Collins, Tyrone J.
Jenkins, J. Stephen
Zhang, Shuyang
Jain, Suresh P.
Ramee, Stephen R.
Title Predictors of stent thrombosis after primary stenting for acute myocardial infarction
Journal name Catheterization and Cardiovascular Interventions   Check publisher's open access policy
ISSN 1522-1946
Publication date 1999-08
Sub-type Article (original research)
DOI 10.1002/(SICI)1522-726X(199908)47:4<415::AID-CCD8>3.0.CO;2-I
Volume 47
Issue 4
Start page 415
End page 422
Total pages 8
Place of publication Hoboken, NJ, United States
Publisher John Wiley & Sons
Language eng
Abstract The aim of the study was to determine if a hypercoagulable state that may persist for several months after an acute myocardial infarction may contribute to an increased incidence of stent thrombosis. Primary stenting was performed in 104 consecutive patients with acute myocardial infarction using 147 coronary stents. Twenty-eight patients (27%) were diabetic and 55 patients (53%) were smokers. A single stent was placed in 63%, two stents in 33%, and more than two stents in 4% of the patients. Procedural success was obtained in 97% of the patients. All stents were deployed using high-pressure balloon inflation. The reference vessel diameter and minimal lumen diameter after stent deployment were 3.30 ± 0.42 and 3.23 ± 0.42 mm, respectively. Six patients (5.7%) developed stent thrombosis within 1 month after the procedure complicated by reinfarction in five of the six patients. At 1-month follow-up, all patients remained alive. On multivariate analysis, independent predictors of stent thrombosis were diabetes mellitus (relative risk [RR] 5.2; 95% confidence interval [CI] 1.8, 25.1), tobacco use (RR 4.5; 95% CI 1.3, 24.5), number of stents: 1 vs. > 1 (RR 3.7; 95% CI 1.1, 15.9), minimal lumen diameter poststent placement (RR 0.03; 95% CI 0.0002, 0.74), and duration of chest pain before intervention (RR 1.1; 95% CI 1.01, 1.25). Stent thrombosis had not been associated with diabetes mellitus and tobacco use previously but is in agreement with the enhanced platelet aggregability, coagulation factor abnormalities, and impaired fibrinolysis characteristic of these patients.
Keyword Ischemia
Abrupt occlusion
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
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Created: Mon, 14 Mar 2011, 10:28:24 EST