Long-Term Clinical Outcomes After
Angiographically Defined Very Late Stent
Thrombosis of Drug-Eluting Stent
- Affiliated Author(s)
- 조윤경; 김형섭; 남창욱; 허승호; 김권배
- Alternative Author(s)
- Cho, Yun Kyeong; Kim, Hyung Seop; Nam, Chang Wook; Hur, Seung Ho; Kim, Kwon Bae
- Journal Title
- Clinical Cardiology
- Issued Date
- 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.
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