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Title: Clinical outcomes following ST-elevation myocardial infarction secondary to stent thrombosis treated by percutaneous coronary intervention.
Austin Authors: Noaman, Samer;O'Brien, Jessica;Andrianopoulos, Nick;Brennan, Angela L;Dinh, Diem;Reid, Christopher;Sharma, Anand;Chan, William;Clark, David J ;Stub, Dion;Biswas, Sinjini;Freeman, Melanie;Ajani, Andrew;Yip, Thomas;Duffy, Stephen J;Oqueli, Ernesto
Affiliation: School of Medicine, Faculty of Health, Deakin University, Geelong, Victoria, Australia
School of Public Health, Curtin University, Perth, Western Australia, Australia
Centre of Cardiovascular Research and Education in Therapeutics (CCRE), Monash University, Melbourne, Victoria, Australia
Department of Cardiology, Royal Melbourne Hospital, Melbourne, Victoria, Australia
Department of Cardiology, Alfred Health, Melbourne, Victoria, Australia
Department of Cardiology, Ballarat Health Services, Ballarat, Victoria, Australia
Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
Department of Cardiology, Geelong University Hospital, Geelong, Victoria, Australia
Department of Cardiology, Box Hill Hospital, Melbourne, Victoria, Australia
University of Melbourne, Melbourne, Victoria, Australia
Issue Date: Oct-2020
Date: 2020-02-22
Publication information: Catheterization and Cardiovascular Interventions 2020; 96(4): E406-E415
Abstract: To assess the clinical outcomes of patients presenting with ST-elevation myocardial infarction (STEMI) secondary to stent thrombosis (ST) compared to those presenting with STEMI secondary to a de novo culprit lesion and treated by percutaneous coronary intervention (PCI). ST is an infrequent but serious complication of PCI with substantial associated morbidity and mortality, however with limited data. We studied consecutive patients who underwent PCI for STEMI from 2005 to 2013 enrolled prospectively in the Melbourne Interventional Group registry. Patients were divided into two groups: the ST group comprised patients where the STEMI was due to ST and the de novo group formed the remainder of the STEMI cohort and all patients were treated by PCI. The primary endpoint was 30-day all-cause mortality. Compared to the de novo group (n = 3,835), the ST group (n = 128; 3.2% of STEMI) had higher rates of diabetes, hypertension and dyslipidemia, established cardiovascular diseases, myocardial infarction, and peripheral vascular disease, all pā€‰<ā€‰.01. Within the ST group, very-late ST was the most common form of ST, followed by late and early ST (64, 19, and 17%, respectively). There was no significant difference in the primary outcome between the ST group and the de novo group (4.7 vs. 7.1%, p = .29). On multivariate analysis, ST was not an independent predictor of 30-day mortality (odds ratio: 0.62, 95% confidence interval: 0.07-1.09, p = .068). The short-term prognosis of patients with STEMI secondary to ST who were treated by PCI was comparable to that of patients with STEMI due to de novo lesions.
DOI: 10.1002/ccd.28802
ORCID: 0000-0002-8760-5373
Journal: Catheterization and Cardiovascular Interventions
PubMed URL: 32087042
Type: Journal Article
Subjects: de novo lesions
myocardial infarction
stent thrombosis
Appears in Collections:Journal articles

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