Key result
Pre-procedure TIMI flow 0 linked to ~227% higher stent thrombosis risk following primary PCI.
Why the study?
Stent thrombosis remains the most feared complication of PCI, motivating an evaluation of acute and sub-acute stent thrombosis incidence, predictors, and outcomes after primary PCI.
Observational (n=1,756)
No
Answers are grounded in this paper and cite their sources.
Acute and sub-acute stent thrombosis occurs in nearly 5% of primary PCI patients and is associated with high mortality, with male gender, elevated LVEDP, and poor initial TIMI flow identified as key predictors.
Background: Stent thrombosis (ST) remains the most feared complication of percutaneous coronary intervention (PCI). Therefore, this study aimed to determine acute and sub-acute ST incidence, predictors, and outcomes after primary PCI. Methods: This prospective observational study included patients who had undergone primary PCI at a tertiary care cardiac center. All the patients were followed at 30-days of index hospitalization for the incidence of acute or sub-acute ST. ST was further categorized as definite, probable, or possible per the Academic Research Consortium definition. All the survivors of ST were followed after 6-months for the incidence of major adverse cardiovascular events. Results: An aggregate of 1756 patients were included with 79% (1388) male patients and mean age was 55.59 ± 11.23 years. The incidence of ST was 4.9% (86) with 1.3% (22) acute and 3.6% (64) sub-acute. ST was categorized as definite in 3.3% (58) and probable in 1.6% (28). Independent predictor of ST were observed to be male gender (odds ratio (OR); 2.51 [1.21-5.2]), left ventricular end-diastolic pressure ≥20 mmHg (OR; 2.55 [1.31-4.98]), and pre-procedure thrombolysis in myocardial infarction (TIMI) flow 0 (OR; 3.27 [1.61-6.65]). Cumulative all-cause mortality among patients with ST after 164.1 ± 76.2 days was 46.5% (40/86). Conclusion: We observed a substantial number of patients vulnerable to the acute or sub-acute ST after primary PCI. Male gender, LVEDP, pre-procedure TIMI flow grade can be used to identify and efficiently manage highly vulnerable patients.
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Kumar et al. (2022) conducted an observational in Acute and sub-acute stent thrombosis after primary percutaneous coronary intervention (n=1,756). Primary percutaneous coronary intervention was evaluated on Incidence of acute or sub-acute stent thrombosis at 30 days. Primary percutaneous coronary intervention was associated with a 4.9% incidence of acute or sub-acute stent thrombosis, with pre-procedure TIMI flow 0 as a strong independent predictor (OR 3.27).
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