Risk factors analysis for early coronary stent thrombosis after drug eluting stent implantation

Abstract

Objective To explore the risk factors for early stent thrombosis (EST) after drug-eluting stent (DES) implantation. Methods A cohort of 20 518 patients who underwent DES implantation in Cangzhou Central Hospital from 2008 to 2018 were retrospectively enrolled. 97 patients with EST were in the EST group and according to the principle of age, gender and risk factors, 194 cases without EST were selected as the control group. Clinical data and coronary lesions characteristics were compared between the two groups. Multivariate logistic regression analysis was used to evaluate risk factors for EST. Results The incidence of EST after DES was 0.5% (107/20 518), and the mortality was 23.4% (25/107). Of 291 patients enrolled, there were 127 males (43.6%), with a mean age of (68.1±8.2) years. Multiple logistic regression analysis showed that hypertriglyceridemia, diffuse lesion, small vessel lesion, multiple stent series, the stent≥30 mm, no second generation DES and no high pressure expansion were risk factors for EST (all P<0.05). Moreover, the small vessel lesion≤2.75 mm was the most strongest risk factor (OR=6.37, 95%CI: 2.51-11.86). Conclusions For patients with risk factors of EST, standardized intervention and enhanced perioperative antithrombotic therapy should be performed, especially for those with small blood vessels and diffuse lesions requiring more stents implanted, thus the second generation DES, and high pressure expansion should be performed to prevent stent malapposition, and reduce the occurrence of EST. Key words: Drug-eluting stent; Coronary artery; Stent thrombosis; Risk factor