Incidence of stent thrombosis in patients with drug eluting stents and short-term dual antiplatelet therapy

EuroIntervention. 2009 Mar;4(5):593-9. doi: 10.4244/eijv4i5a100.

Abstract

Aims: This study sought to investigate the incidence of stent thrombosis (ST) in patients treated with drug-eluting stents (DES) and clearly defined short-term dual antiplatelet therapy (DAT) for three or six months for sirolimus-eluting stents (SES) or paclitaxel-eluting stents (PES), respectively.

Methods and results: A series of 1023 consecutive patients with 1,414 stented lesions and prescribed short-term DAT were followed for at least two years after DES implantation. The individual durations of DAT, the rate of ischaemic events, and survival status were assessed. Follow-up was completed for 1017 patients (99.4%) with a mean follow-up of 3.0 +/- 0.7 years. DAT duration was 2.8 +/- 0.4 and 5.9 +/- 0.8 months in patients with SES and PES, respectively. Adherence to continued single antiplatelet therapy was 98.4%. We identified 14 patients with definite ST (1.4%) and no patients with probable ST with a cumulative incidence of 0.6% at 30 days, of 0.8% at one year, of 1.2% at 2 years, and of 1.4% at three years.

Conclusions: Definite or probable ST after DES implantation and short DAT occurs with a cumulative incidence of 1.4% at 3 years if excellent patient adherence to the continued single antiplatelet therapy can be achieved.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Angioplasty, Balloon, Coronary / adverse effects*
  • Angioplasty, Balloon, Coronary / instrumentation*
  • Aspirin / administration & dosage*
  • Cardiovascular Agents / administration & dosage
  • Clopidogrel
  • Coronary Artery Disease / therapy*
  • Databases as Topic
  • Drug Administration Schedule
  • Drug-Eluting Stents*
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Kaplan-Meier Estimate
  • Male
  • Medication Adherence
  • Middle Aged
  • Paclitaxel / administration & dosage
  • Platelet Aggregation Inhibitors / administration & dosage*
  • Sirolimus / administration & dosage
  • Thrombosis / epidemiology
  • Thrombosis / etiology*
  • Thrombosis / prevention & control
  • Ticlopidine / administration & dosage
  • Ticlopidine / analogs & derivatives*
  • Time Factors
  • Treatment Outcome

Substances

  • Cardiovascular Agents
  • Platelet Aggregation Inhibitors
  • Clopidogrel
  • Ticlopidine
  • Paclitaxel
  • Aspirin
  • Sirolimus