Stent Thrombosis after Rescue Percutaneous Coronary Intervention in Acute ST-Segment Elevation Myocardial Infarction



Khalid Bin Thani1, *, Fajer Al-Moosa1, Eman Murad1, Aisha Al-Moosa1, Mohamed E. Alalawi1, Hind Al-Sindi2
1 Salmaniya Medical Complex, Division of Cardiology, Department of Internal Medicine, Manama, Kingdom of Bahrain
2 Primary Care and Family Physician Program, Ministry of Health, Manama, Kingdom of Bahrain


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© Thani et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution-Non-Commercial 4.0 International Public License (CC BY-NC 4.0) (https://creativecommons.org/licenses/by-nc/4.0/legalcode), which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Division of Cardiology, Department of Internal Medicine, Salmaniya Medical Complex, P.O. Box 12, Manama, Kingdom of Bahrain; Tel: (+973) 17-279750; Fax: (+973) 17-279774; E-mail: genfith@hotmail.com


Abstract

Main Problem:

To determine the incidence of coronary stent thrombosis (ST) in patients with acute ST segment elevation myocardial infarction (STEMI) after rescue percutaneous coronary intervention (PCI).

Methods:

An observational study looking at the incidence of ST in a middle-eastern population. A total of 510 consecutive patients presented with ST-segment elevation myocardial infarction (STEMI) were enrolled and underwent thrombolytic therapy with a total follow-up period of 2 years. Study outcomes were ST, death, re-infarction or acute coronary syndrome requiring coronary angiography and PCI.

Results:

A total of 510 patients enrolled, all diagnosed with STEMI and underwent thrombolytic therapy. Only 100 subjects underwent rescue PCI with intra-coronary stenting, including 54 patients with drug-eluting stent (DES) and 46 patients with bare metal stent (BMS). During the study period and follow-up, the overall rate of ST was 13.7%, definite ST occurred in 6 patients (5.5%), probable ST in 8 patients (7.3%), and possible ST in one patient (0.9%), including 0.9% acute ST, 0.9% sub-acute ST, 2.8% late ST and 8.3% very late ST. Patients with ST were likely to have prior PCI (p=0.001), prior coronary artery bypass grafting (CABG) (p=0.002) and history of heart failure (p=0.04).

Conclusion:

ST is infrequent event with major consequences in patients presenting with STEMI in the first 2 years after stent implantation.

Keywords: Acute myocardial Infarction, Arab, Bahrain, Gulf States, Middle East, Stent Thrombosis, STEMI.