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Clinical Impact of ...
Clinical Impact of Intraprocedural Stent Thrombosis During Percutaneous Coronary Intervention in Patients Treated With Potent P2Y12 inhibitors : a VALIDATE-SWEDEHEART Substudy
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- Bergman, Sofia (author)
- Lund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital,Lund Univ, Dept Cardiol, Clin Sci, Skane Univ Hosp, S-22185 Lund, Sweden.
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- Mohammad, Moman A. (author)
- Lund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital,Lund Univ, Dept Cardiol, Clin Sci, Skane Univ Hosp, S-22185 Lund, Sweden.
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- James, Stefan, 1964- (author)
- Uppsala universitet,Uppsala University,Kardiologi,Uppsala kliniska forskningscentrum (UCR)
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- Angerås, Oskar, 1976 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine
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- Wagner, Henrik (author)
- Lund University,Lunds universitet,Kliniska Vetenskaper, Helsingborg,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Clinical Sciences, Helsingborg,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Helsingborg Hospital,Helsingborg Lasarett, Dept Cardiol, Helsingborg, Sweden.
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- Jensen, Jens (author)
- Karolinska Institutet,Karolinska Institute,Capio St. Görans Sjukhus,Karolinska Inst, Sodersjukhuset, Dept Clin Sci & Educ, Stockholm, Sweden.;Capio St Gorans Hosp AB, Dept Cardiol, Stockholm, Sweden.
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- Scherstén, Fredrik (author)
- Lund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital,Lund Univ, Dept Cardiol, Clin Sci, Skane Univ Hosp, S-22185 Lund, Sweden.
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- Fröbert, Ole, 1964- (author)
- Örebro University,Örebro universitet,Institutionen för medicinska vetenskaper,Department of Cardiology,Örebro Univ, Dept Cardiol, Fac Hlth, Örebro, Sweden.
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- Koul, Sasha (author)
- Lund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital,Lund Univ, Dept Cardiol, Clin Sci, Skane Univ Hosp, S-22185 Lund, Sweden.
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- Erlinge, David (author)
- Lund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital,Lund Univ, Dept Cardiol, Clin Sci, Skane Univ Hosp, S-22185 Lund, Sweden.
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(creator_code:org_t)
- John Wiley & Sons, 2021
- 2021
- English.
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In: Journal of the American Heart Association. - : John Wiley & Sons. - 2047-9980. ; 10:18
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Abstract
Subject headings
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- Background: The clinical importance of intraprocedural stent thrombosis (IPST) during percutaneous coronary intervention in the contemporary era of potent oral P2Y12 inhibitors is not established. The aim of this study was to assess IPST and its association with clinical outcome in patients with myocardial infarction undergoing percutaneous coronary intervention with contemporary antithromboticmedications.Methods and Results: The VALIDATE-SWEDEHEART study (Bivalirudin Versus Heparin in ST-Segment and Non-ST-Segment Elevation Myocardial Infarction in Patients on Modern Antiplatelet Therapy in the Swedish Web System for Enhancement and Development of Evidence-Based Care in Heart Disease Evaluated According to Recommended Therapies Registry Trial) included 6006 patients with myocardial infarction, treated with potent P2Y12 inhibitors during percutaneous coronary intervention. IPST, defined as a new or worsening thrombus related to a stent deployed during the procedure, was reported by the interventional cardiologist in 55 patients (0.9%) and was significantly associated with ST-segment elevation myocardial infarction presentation, longer stents, bailout glycoprotein IIb/IIIa inhibitors, and final Thrombolysis in Myocardial Infarction flow <3. The primary composite end point included cardiovascular death, myocardial infarction, out-of-laboratory definite stent thrombosis and target vessel revascularization within 30 days. Secondary end points were major bleeding and the individual components of the primary composite end point. Patients with versus without IPST had significantly higher rates of the primary composite end point (20.0% versus 4.4%), including higher rates of cardiovascular death, target vessel revascularization, and definite stent thrombosis, but not myocardial infarction or major bleeding. By multivariable analysis, IPST was independently associated with the primary composite end point (hazard ratio, 3.82; 95% CI, 2.05-7.12; P<0.001).Conclusions: IPST is a rare but dangerous complication during percutaneous coronary intervention, independently associated with poor prognosis, even in the current era of potent antiplatelet agents. Future treatment studies are needed to reduce the rate of IPST and to improve the poor outcome among these patients. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT02311231.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- Intraprocedural stent thrombosis
- myocardial infarction
- oral P2Y12 inhibitors
- percutaneous coronary intervention
- stent thrombosis
- Intraprocedural stent thrombosis
- Myocardial infarction
- Oral P2Y12 inhibitors
- Percutaneous coronary intervention
- Stent thrombosis
Publication and Content Type
- ref (subject category)
- art (subject category)
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Bergman, Sofia
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Mohammad, Moman ...
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James, Stefan, 1 ...
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Angerås, Oskar, ...
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Wagner, Henrik
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Jensen, Jens
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Scherstén, Fredr ...
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Fröbert, Ole, 19 ...
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Koul, Sasha
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Erlinge, David
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
- Articles in the publication
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Journal of the A ...
- By the university
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Örebro University
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Lund University
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Uppsala University
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Karolinska Institutet
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University of Gothenburg