Incidence and Outcomes of Early Stent Thrombosis in Patients Receiving Drug-eluting Stents: A Retrospective Study from a Tertiary Care Centre in India OC01-OC05
Dr. Gaurav Chaudhary,
Assistant Professor, Department of Cardiology, King Georgeâ€™s Medical University, Shah Mina Road, Chowk,
Lucknow-226003, Uttar Pradesh, India.
Introduction: Early stent thrombosis is a relatively rare but deleterious complication of Percutaneous Coronary Intervention (PCI). Data on early stent thrombosis from an Indian setting are rare and indistinct.
Aim: To determine the incidence and clinical outcomes of early stent thrombosis in patients receiving drug-eluting stents.
Materials and Methods: In this retrospective study, data of all consecutive patients who underwent PCI with stenting and reported an incidence of early stent thrombosis between March 2014 and November 2016 at our Tertiary Care Centre (King Georgeâ€™s Medical University, Lucknow, India) were considered. Incidence of early stent thrombosis was determined based on total number of patients who underwent PCI with drug-eluting stents during the study period. Subsequently, the patient-related, lesion-related, procedure-related, and stent-related characteristics were examined for patients with early stent thrombosis. Clinical outcomes of stent thrombosis were also analysed for these patients. Additionally, a comparative analysis for various characteristics was performed between patients who died and patients who survived.
Results: Early thrombosis was noted in 41 (1%) patients out of 3,869 PCI that were performed during the study period. Among this cohort, substantial presence of established risk factors of stent thrombosis was observed including for diabetes (n=12, 29.3%), smoking (n=19, 46.3%), STEMI (n=30, 73.2%), chronic total occlusion (n=8, 16.3%), thrombus-containing lesion (n=24, 49%), Type C lesions (n=36, 73.5%). Although, all patients were aimed to manage appropriately, mortality in patients with early stent thrombosis was reported in 18 (43.9%) patients and re-infarct was reported in 26.8% (n=11) patients.
Conclusion: Although, the incidence of stent thrombosis in patients receiving drug-eluting stents was around 1%, it was found to be associated with a higher 30-day mortality rate. Further studies examining a larger cohort of patients, incidence of late and very late stent thrombosis, and a comparative analysis of characteristics between patients with and without stent thrombosis are warranted.