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Contemporary management of stent thrombosis: Predictors of mortality and the role of new-generation drug-eluting stents

Catheterization and Cardiovascular Interventions Sep 17, 2019

Katsikis A, Keeble TR, Davies JR, et al. - In this investigation involving 131 patients, researchers assessed mortality predictors and the role of new-generation drug-eluting stents (NG-DES) in the management of stent thrombosis (ST). The study considered patients with definite ST of DES or BMS who underwent urgent/emergent angiography between 2015 and 2018. Data reported that mode of presentation was STEMI in 88% and UA/NSTEMI in 12%. In 11, 4, and 85%, respectively, ST type was early, late, and very late. Non-stent treatment (medical management, thromboaspiration, balloon-angioplasty), TIMI-2 flow and GFR < 60 mL/min were independent predictors of all-cause death for patients discharged alive. In patients discharged alive, different predictors were noted for in-hospital mortality and mortality after ST management. A novel observation is the best outcome with NG-DES treatment, which warrants further studies to elucidate if associated with factors related to stent or patient.
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