Long-Term Clinical Outcomes After Angiographically Defined Very Late Stent Thrombosis of Drug-Eluting Stent

Authors
Ung KimDong-Kie KimYoung-Bok KimSang-Hoon SeolTae-Hyun YangDae-Kyeong KimDoo-Il KimDong-Soo KimSang-Hee LeeGeu-Ru HongJong-Seon ParkDong-Gu ShinYoung-Jo KimYoon-Kyung ChoHyung-Seop KimChang-Wook NamSeung-Ho HurKwon-Bae Kim
Department
Dept. of Internal Medicine (내과학)
Issue Date
2009
Citation
Clinical Cardiology, Vol.32(9) : 526-529, 2009
ISSN
0160-9289
Abstract
Background: The advent of drug-eluting stent (DES) use has raised concerns regarding later occurring stent thrombosis, especially very late stent thrombosis (VLST), and little is known about long-term clinical outcomes after VLST occurrence. Hypothesis: Long-term clinical outcomes after detection of VLST may be poor. Method: We evaluated 3572 consecutive patients who received DES implantation from May 2004 to July 2007 at 3 hospitals. The primary outcomes were a composite of major adverse cardiac events (MACE) including cardiac death, myocardial infarction (MI), target-lesion revascularization (TLR), and target-vessel revascularization (TVR) after VLST occurrence. Results: We identified 19 patients (0.53%) with angiographically documentedstent thrombosis developingover 1 year after DES implantation. The mean time to VLST occurrence was 899 days (899 ± 353). Discontinuation of antiplatelet drugs was noted in 4 (21%) patients and the average duration of discontinuation was 4 days. Clinical presentations of VLST were mainly MI (17 patients, 89%). Balloon angioplasty was only performed in 12 patients (63%) and stent implantation in 7 patients (37%). Mean follow-up duration from VLST occurrence was 620 days (620 ± 256). During clinical follow-up after VLST occurrence, no cardiac deaths or MIs were detected. Target-vessel revascularization was done in 2 (11%) patients and TLR in 1 patient (6%). Major adverse cardiac events occurred in 3 (16%) patients during long-term clinical follow-up. Conclusions: Clinical presentation of VLST after DES implantation is associated with serious adverse events, such as MI. Long-term follow-up outcomes after VLST occurrence appear unfavorable and more data from larger studies are warranted.
URI
http://kumel.medlib.dsmc.or.kr/handle/2015.oak/35485
Appears in Collections:
1. Journal Papers (연구논문) > 1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
Keimyung Author(s)
조윤경; 김형섭; 남창욱; 허승호; 김권배
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