Acute and Sub-acute Stent Thrombosis after Emergency Percutaneous Coronary Revascularization with Drug-eluting Stents: A Prospective Observational Study of Incidence, Predictors, and Outcomes

Abstract

This chapter aimed to determine acute and sub-acute Stent thrombosis (ST) incidence, predictors, and outcomes after primary percutaneous coronary intervention (PCI). Patients who had undergone primary PCI at a tertiary care cardiac center were included in this prospective observational study. All patients were followed up on 30 days after their initial hospitalization to see if they developed acute or subacute ST. An aggregate of 1756 patients were included with 79% (1388) male patients and mean age was 55.59 ± 11.23 years. The findings showed that 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 noticed to be male gender (odds ratio (OR); 2.51 [1.21–5.2]), left ventricular end-diastolic pressure \(\ge\) 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]). After primary PCI, we found a significant number of patients who were susceptible to acute or subacute ST. Male gender, LVEDP, and pre-procedure TIMI flow grade can all be used to identify and manage high-risk patients.