Abstract 2559: Impact of Stent Thrombosis On MACE In The ARTS-II Study

Abstract

PURPOSE: There is still scarce data about the incidence of (late) stent thrombosis (ST) following implantation of drug-eluting stents in patients treated for multivessel coronary artery disease (MVD). Recent concerns were raised about a possible erosion of the long-term treatment benefit of sirolimus-eluting stents (SES) due to ST. Our aim was to assess the impact of ST on Major Adverse Cardiac Events (MACE) up to 3 years in patients treated with SES for MVD in the Arterial Revascularization Therapies Study part II (ARTS-II) trial. METHODS: ARTS-II is a non-randomized, open label, stratified trial with 607 patients exclusively treated with SES for multivessel coronary artery disease including mandatory involvement of the LAD. The 3-year clinical data from ARTS-II were re-adjudicated by an independent clinical events committee for the incidence of ST according to the definitions recently proposed by an Academic Research Consortium (ARC) using the categories of definite (angiography or autopsy), probable (myocardial infarction in target area, unexplained death within 30 days), and possible ST (unexplained death). RESULTS: The majority of patients (53.5%) had 3-vessel disease. Total stented length was 72.5 ± 32.1mm, and 3.7 ± 1.5 stents were implanted per patient on average. At 3 years, 18/607patients died (3.0%), and MI was observed in 49/607 patients (8.1%). Stent thrombosis occurred in 39/607 patients (6.4%), 21 patients had ``definite” ST, and 32 patients had ``definite or probable” ST according to the ARC classification. From the 39 patients experiencing ST only 8 died, 7 of which were contributed by the ARC ``possible” ST category. CONCLUSIONS: In ARTS-II, the majority of deaths in patients with ST was contributed by the ARC possible category. The final impact of ST on the individual MACE categories will be presented at the conference.