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Stent Thrombosis in Sweden A Report From the Swedish Coronary Angiography and Angioplasty Registry

Lagerqvist, Bo; Carlsson, Jorg; Frobert, Ole; Lindback, Johan; Scherstén, Fredrik LU ; Stenestrand, Ulf and James, Stefan K. (2009) In Circulation. Cardiovascular Interventions 2(5). p.401-408
Abstract
Background-The objective was to evaluate the role of risk factors and stent type for stent thrombosis (ST) using a large real world registry. Methods and Results-We evaluated all consecutive coronary stent implantations in Sweden from May 1, 2005, to June 30, 2007. All cases of ST, documented in the Swedish coronary angiography and angioplasty registry until September 21, 2008, were analyzed. ST was registered in 882 of 73 798 stents. Acute coronary syndromes, insulin-treated diabetes mellitus, smoking, previous coronary intervention, warfarin treatment, small stent diameter, and stenting in restenotic, complex, or bypass graft lesions had the strongest association with ST in the multivariable statistical model. There were considerable... (More)
Background-The objective was to evaluate the role of risk factors and stent type for stent thrombosis (ST) using a large real world registry. Methods and Results-We evaluated all consecutive coronary stent implantations in Sweden from May 1, 2005, to June 30, 2007. All cases of ST, documented in the Swedish coronary angiography and angioplasty registry until September 21, 2008, were analyzed. ST was registered in 882 of 73 798 stents. Acute coronary syndromes, insulin-treated diabetes mellitus, smoking, previous coronary intervention, warfarin treatment, small stent diameter, and stenting in restenotic, complex, or bypass graft lesions had the strongest association with ST in the multivariable statistical model. There were considerable differences in the frequency of ST between different stent brands. The overall risk of ST was lower in drug-eluting stents compared with bare metal stents (adjusted risk ratio, 0.79; 99% CI, 0.63 to 0.99). However, from 6 months after stent implantation and onward, the risk for ST was higher in drug-eluting stents compared with bare metal stents (adjusted risk ratio, 2.02; 99% CI, 1.30 to 3.14). Conclusions-ST is a multifactor disease, and the incidence varies considerably between patients based on clinical, vessel, and stent characteristics. For drug-eluting stents compared with bare metal stents, the risk pattern was biphasic; initially, bare metal stents demonstrated a higher risk of ST; whereas after the first months, ST risk was higher with drug-eluting stents. Our findings highlight the need for prospective randomized studies with head-to-head comparisons between different stents. (Circ Cardiovasc Intervent. 2009;2:401-408.) (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
revascularization, angioplasty, myocardial infarction, stent, thrombosis
in
Circulation. Cardiovascular Interventions
volume
2
issue
5
pages
401 - 408
publisher
American Heart Association
external identifiers
  • wos:000276068800006
  • scopus:73949085452
ISSN
1941-7632
DOI
10.1161/CIRCINTERVENTIONS.108.844985
language
English
LU publication?
yes
id
1d8bc012-98d2-4de7-8336-847fc5f139a6 (old id 1586362)
date added to LUP
2010-04-28 09:38:10
date last changed
2017-12-10 03:52:34
@article{1d8bc012-98d2-4de7-8336-847fc5f139a6,
  abstract     = {Background-The objective was to evaluate the role of risk factors and stent type for stent thrombosis (ST) using a large real world registry. Methods and Results-We evaluated all consecutive coronary stent implantations in Sweden from May 1, 2005, to June 30, 2007. All cases of ST, documented in the Swedish coronary angiography and angioplasty registry until September 21, 2008, were analyzed. ST was registered in 882 of 73 798 stents. Acute coronary syndromes, insulin-treated diabetes mellitus, smoking, previous coronary intervention, warfarin treatment, small stent diameter, and stenting in restenotic, complex, or bypass graft lesions had the strongest association with ST in the multivariable statistical model. There were considerable differences in the frequency of ST between different stent brands. The overall risk of ST was lower in drug-eluting stents compared with bare metal stents (adjusted risk ratio, 0.79; 99% CI, 0.63 to 0.99). However, from 6 months after stent implantation and onward, the risk for ST was higher in drug-eluting stents compared with bare metal stents (adjusted risk ratio, 2.02; 99% CI, 1.30 to 3.14). Conclusions-ST is a multifactor disease, and the incidence varies considerably between patients based on clinical, vessel, and stent characteristics. For drug-eluting stents compared with bare metal stents, the risk pattern was biphasic; initially, bare metal stents demonstrated a higher risk of ST; whereas after the first months, ST risk was higher with drug-eluting stents. Our findings highlight the need for prospective randomized studies with head-to-head comparisons between different stents. (Circ Cardiovasc Intervent. 2009;2:401-408.)},
  author       = {Lagerqvist, Bo and Carlsson, Jorg and Frobert, Ole and Lindback, Johan and Scherstén, Fredrik and Stenestrand, Ulf and James, Stefan K.},
  issn         = {1941-7632},
  keyword      = {revascularization,angioplasty,myocardial infarction,stent,thrombosis},
  language     = {eng},
  number       = {5},
  pages        = {401--408},
  publisher    = {American Heart Association},
  series       = {Circulation. Cardiovascular Interventions},
  title        = {Stent Thrombosis in Sweden A Report From the Swedish Coronary Angiography and Angioplasty Registry},
  url          = {http://dx.doi.org/10.1161/CIRCINTERVENTIONS.108.844985},
  volume       = {2},
  year         = {2009},
}