Major risk factors of stent thrombosis in patients with acute coronary syndrome (in Russian only)

Korotaeva E.S.; Koroleva L.Yu.; Nosov V.P.; Kovaleva G.V.; Kuzmenko E.A.

doi:https://doi.org/10.17116/kardio201912041329

Korotaeva E.S.

Privolzhsky Research Medical University of Health Ministry of Russia, Nizhny Novgorod, Russia

Koroleva L.Yu.

N.A. Semashko Nizhny Novgorod Regional Clinical Hospital, Cheir of Hospital Therapy of Nizhny Novgorod State Medical Academy, Health Ministry of the Russian Federation

Nosov V.P.

Nizhny Novgorod State Medical Academy of Healthcare Ministry of the Russia Nizhny Novgorod, Russia

Kovaleva G.V.

N.A. Semashko Nizhny Novgorod Regional Clinical Hospital, Cheir of Hospital Therapy of Nizhny Novgorod State Medical Academy, Health Ministry of the Russian Federation

Kuzmenko E.A.

Semashko Nizhny Novgorod Regional Clinical Hospital, Nizhny Novgorod, Russia

Major risk factors of stent thrombosis in patients with acute coronary syndrome (in Russian only)

Authors:

Korotaeva E.S., Koroleva L.Yu., Nosov V.P., Kovaleva G.V., Kuzmenko E.A.

More about the authors

Journal: Russian Journal of Cardiology and Cardiovascular Surgery. 2019;12(4): 329‑335

DOI: 10.17116/kardio201912041329

Read: 4926 times

To cite this article:

Korotaeva ES, Koroleva LYu, Nosov VP, Kovaleva GV, Kuzmenko EA. Major risk factors of stent thrombosis in patients with acute coronary syndrome (in Russian only). Russian Journal of Cardiology and Cardiovascular Surgery. 2019;12(4):329‑335. (In Russ., In Engl.)
https://doi.org/10.17116/kardio201912041329

Подписка 2026 Кардиология и сердечно-сосудистая хирургия (Russian Journal of Cardiology and Cardiovascular Surgery)

Использование инфографики авторами научных работ

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Abstract:

Abstract Objective — to analyze risk factors of stent thrombosis (ST) in patients with acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI) and administration of dual anti-platelet therapy (DATT). Material and methods. There were 25 (1.1%) out of the 2378 patients with confirmed ST who underwent PCI with stenting for ACS in 2016—2018. These patients were included into the main group. The control group consisted of 158 patients without ST according to 12-month follow-up. Clinical, laboratory, instrumental, angiographic data and adherence to therapy were analyzed. Statistical analysis was performed using Statistica version 10.0 and MedCalc Software version 11.5.0. Results. The following significant risk factors of ST associated with patient’s condition were identified: severe acute heart failure (AHF) (Killip grade III—IV) (p<0.0001), ST elevation ACS (p=0.006), reduced left ventricular ejection fraction (p<0.0001), insulin-dependent diabetes mellitus type 2 (p=0.008), in-hospital paroxysmal tachyarrhythmias complicating the course of ACS (atrial fibrillation (p=0.001) and ventricular fibrillation (p=0.003). The most significant risk factors associated with coronary lesion and technical features of the procedure were acute occlusion of infarct-related artery (p=0.002), parietal thrombus (grade 1—5) before the primary PCI (p=0.0005), coronary artery dissection (p=0.0001), no-reflow phenomenon (p=0.02). There was a significant correlation between ST and low adherence to DATT (Moriscos—Green score 3 or less) (τ =0.61; p<0.0001). Conclusion. There is a multifactorial effect on the development of ST including patient-associated factors, features of coronary lesion and interventional techniques.

Keywords:

stent thrombosis

acute coronary syndrome

percutaneous coronary intervention

adherence

Authors:

Korotaeva E.S.

Privolzhsky Research Medical University of Health Ministry of Russia, Nizhny Novgorod, Russia

Koroleva L.Yu.

N.A. Semashko Nizhny Novgorod Regional Clinical Hospital, Cheir of Hospital Therapy of Nizhny Novgorod State Medical Academy, Health Ministry of the Russian Federation

Nosov V.P.

Nizhny Novgorod State Medical Academy of Healthcare Ministry of the Russia Nizhny Novgorod, Russia

Kovaleva G.V.

N.A. Semashko Nizhny Novgorod Regional Clinical Hospital, Cheir of Hospital Therapy of Nizhny Novgorod State Medical Academy, Health Ministry of the Russian Federation

Kuzmenko E.A.

Semashko Nizhny Novgorod Regional Clinical Hospital, Nizhny Novgorod, Russia

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References:

Jaffe R, Strauss BH. Late and very late thrombosis of drug eluting stents: evolving concepts and perspectives. J Amer Coll Cardiol. 2007;50:119-127. https://doi.org/10.1016/j.jacc.2007.04.031
Histopathological evaluation of thrombus in patients presenting with stent thrombosis. A multicenter European study: a report of the prevention of late stent thrombosis by an interdisciplinary global European effort consortium. Eur Heart J. 2016;37(19):1538-1549. https://doi.org/10.1093/eurheartj/ehv419
Urban P, Gershlick AH, Guagliumi G, et al. Safety of coronary sirolimus-eluting stents in daily clinical practice: one-year follow-up of the e-Cypher registry. Circulation. 2006;113:11:1434-1441. https://doi.org/10.1161/circulationaha.104.532242
Roy P, Torguson R, Okabe T, et al. Comparison between sirolimus- and paclitaxel-eluting stents in complex patient and lesions subsets. Catheter Cardiovasc Interv. 2007;70:2:167-172. https://doi.org/10.1002/ccd.21122
Nuñez López VF, Cohen MG. The elusive prediction of stent thrombosis. Catheter Cardiovasc Interv. 2017 Jan; 89(1):35-36. https://doi.org/10.1002/ccd.26897
Spaulding C, Henry P, Teiger E, et al. Sirolimus-eluting versus uncoated stents in acute myocardial infarction. N Engl J Med. 2006;355:1093-1010. https://doi.org/10.1056/nejmoa062006
Cutlip DE, Windecker S, Mehran R. Clinical end points in coronary stent trials: a case for standardized definitions. Circulation. 2007;115:2344-2351. https://doi.org/10.1161/circulationaha.106.685313
ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC) 2017. Eur Heart J. 2017 Aug;26. https://doi.org/10.1093/eurheartj/ehx393
Morisky DE, Green LW, Levine DM. Concurrent and predictive validity of a self-reported measure of medication adherence. Med Care. 1986 Jan;24(1):67-74. https://doi.org/10.1097/00005650-198601000-00007
Roffi M, Patrono C, Collet JP, Mueller C, et al. 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: Task Force for the Management of Acute Coronary Syndromes in Patients Presenting without Persistent ST-Segment Elevation of the European Society of Cardiology (ESC). Eur Heart J. 2016;37:267-315. https://doi.org/10.1093/eurheartj/ehv320
Fox KA, Dabbous OH, Goldberg RJ, et al. Prediction of risk of death and myocardial infarction in the six months after presentation with acute coronary syndrome: prospective multinational observational study (GRACE). BMJ. 2006;333(7578):1091-1094. https://doi.org/10.1136/bmj.38985.646481.55
Sianos G, Papafaklis MI, Serruys PW. Angiographic thrombus burden classification in patients with ST-segment elevation myocardial infarction treated with percutaneous coronary intervention. J Invasive Cardiol. 2010;22:6B-14B.
Gibson CM, de Lemos JA, Murphy SA, et al. Combination therapy with abciximab reduces angiographically evident thrombus in acute myocardial infarction: a TIMI 14 substudy. Circulation. 2001 May 29;103(21):2550-2554. https://doi.org/10.1161/01.cir.103.21.2550
Cheneau E, Leborgne L, Mintz GS, et al. Predictors of subacute stent thrombosis. Results of a systematic intravascular ultrasound study. Circulation. 2003;108:43-47. https://doi.org/10.1016/j.accreview.2003.09.006
Iakovou I, Schmidt T, Bonizzoni E, Ge L, et al. Incidence, predictors, and outcome of thrombosis after successful implantation of drug eluting stents. JAMA. 2005;293(17):2126-2130.
Carr M. E. Diabetes mellitus: a hypercoagulable state. J Diabetes Complications. 2001;15:44-54.
Luscher TF, Steffel J, Eberli FR, Joner M, Nakazawa G, Tanner FC, Virmani R. Drug-eluting stent and coronary thrombosis : biological mechanisms and clinical implications. Circulation 2007;115(8):1051-1058.
Ge L, Airoldi F, Iakovou I, et al. Clinical and angiographic outcome after implantation of drugeluting stents in bifurcation lesions with the crush stent technique: importance of final kissing balloon post-dilation. J Am Coll Cardiol. 2005 Aug 16;46(4):613-620. https://doi.org/10.1016/j.jacc.2005.05.032
Mauri L, Hsieh WH, Massaro JM, et al. Stent thrombosis in randomized clinical trials of drug-eluting stents. N Engl J Med. 2007;356(10):1020-1029. https://doi.org/10.1056/NEJMoa067731
Ruda MYa, Kuzmin AI, Merkulova IN, et al. Spontaneous reperfusion of the artery responsible for the development of myocardial infarction in patients with myocardial infarction with ST segment elevation. Terapevticheskiy arkhiv. 2009;5:20-29. (In Russ.)
Aoki J, Lansky AJ, Mehran R, et al. Early stent thrombosis in patients with acute coronary syndromes treated with drug-eluting and bare metal stents: the Acute Catheterization and Urgent Intervention Triage Strategy trial. Circulation. 2009;119:687-698.