TY - JOUR
T1 - Predictors for very late stent thrombosis after drug-eluting stent implantation in diabetic patients
AU - Voudris, Vassilis
AU - Kariofillis, Panagiotis
AU - Thomopoulou, Sophia
AU - Patsilinakos, Sotiris
AU - Manginas, Athanasios
AU - Spargias, Constantinos
AU - Pavlides, Gregory
AU - Cokkinos, Dennis V.
PY - 2009/1
Y1 - 2009/1
N2 - Aims: Despite encouraging results with drug-eluting stents (DES) reported in diabetic patients, the longterm safety is unknown because of very late stent thrombosis (VLST). We investigated the incidence, risk factors and clinical manifestations of VLST in diabetic patients treated with DES, during long-term clinical follow-up. Methods and results: A total of 610 consecutive diabetic patients underwent PCI with DES. Dual antiplatelet treatment (APLT) for 12 months received 93%, more than 12 months 72% and statin treatment 93% of patients. Clinical follow-up of at least 12 months post DES implantation was obtained in 597/610 (98%) patients. The incidence of VLST was 1.8%, and 1.7% of patients developed stent thrombosis (ST) up to 12 months. All patients with VLST presented with sudden cardiac death and 82% were on dual APLT at the time of the event. In a multivariate model the only predictor for VLST (HR: 20.58, 95% CI 5.17-81.90, p<0.001) and overall ST (HR: 4.38, 95% CI 1.73-11.10, p=0.002) was ejection fraction < 40%. Conclusions: The incidence of ST in diabetic patients undergoing PCI with DES and receiving dual APLT is low at long-term clinical follow-up. The only predictor for VLST and overall ST was depressed left ventricular systolic function.
AB - Aims: Despite encouraging results with drug-eluting stents (DES) reported in diabetic patients, the longterm safety is unknown because of very late stent thrombosis (VLST). We investigated the incidence, risk factors and clinical manifestations of VLST in diabetic patients treated with DES, during long-term clinical follow-up. Methods and results: A total of 610 consecutive diabetic patients underwent PCI with DES. Dual antiplatelet treatment (APLT) for 12 months received 93%, more than 12 months 72% and statin treatment 93% of patients. Clinical follow-up of at least 12 months post DES implantation was obtained in 597/610 (98%) patients. The incidence of VLST was 1.8%, and 1.7% of patients developed stent thrombosis (ST) up to 12 months. All patients with VLST presented with sudden cardiac death and 82% were on dual APLT at the time of the event. In a multivariate model the only predictor for VLST (HR: 20.58, 95% CI 5.17-81.90, p<0.001) and overall ST (HR: 4.38, 95% CI 1.73-11.10, p=0.002) was ejection fraction < 40%. Conclusions: The incidence of ST in diabetic patients undergoing PCI with DES and receiving dual APLT is low at long-term clinical follow-up. The only predictor for VLST and overall ST was depressed left ventricular systolic function.
KW - Angioplasty
KW - Diabetes
KW - Drug eluting stent
KW - Stent thrombosis
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U2 - 10.4244/EIJV4I4A83
DO - 10.4244/EIJV4I4A83
M3 - Article
C2 - 19284071
AN - SCOPUS:63049099108
VL - 4
SP - 485
EP - 491
JO - EuroIntervention
JF - EuroIntervention
SN - 1774-024X
IS - 4
ER -