<h3>Introduction</h3> Despite major advances in coronary stent technology, stent thrombosis (ST) remains a significant complication of percutaneous coronary intervention (PCI) with a high rate of MI and death. The underlying mechanisms are multi-factorial and poorly understood. Previous studies have involved small sample sizes, with incomplete patient characterisation, a lack of intracoronary imaging or platelet function data. <h3>Methods</h3> As part of the European multi-centre <b>PRESTIGE project</b>, we established and coordinated a ST study, collecting multi-source data from patients presenting with definite ST between April 2012 and October 2014 at 12 UK cardiac centres. <b>Demographic</b> and <b>clinical data</b> were collected and all <b>angiographic images</b> reviewed. <b>Intracoronary thrombus</b> was examined histopathologically and <b>intravascular ultrasound (IVUS) and/or optical coherence tomography (OCT) </b>performed whenever possible. We undertook <b>platelet function testing </b>(PFT) acutely, at 24 h and at 30–60 days, and collected blood for t<b>hrombin generation assays</b> and <b>DNA analysis</b>. All non-invasive studies including PFT were also undertaken in an average of 2.6 matched controls per ST case. <h3>Results</h3> A total of <b>138 patients </b>with definite ST were recruited in the UK, with <b>353 controls</b>. Of the ST cases, <b>4.3% were acute</b> (within 24 h), <b>18.8% sub-acute</b> (24 h to 1 month), <b>8.7% late </b>(1–12 months) and <b>68.1% very late</b> (> 1 year) after the initial PCI. PFT was carried out in 74.6% and 86.4% of the ST patients and controls respectively, and 89.1% of the ST cases and 98.0% of the control patients had a blood sample stored for DNA analysis. Of the ST cases, 63.8% had thrombus retained, 38.4% had IVUS and 21.7% had OCT imaging. The ST cases and control groups were well matched for <b>gender, hypertension, heart failure, renal impairment</b> and <b>indication for PCI.</b> The ST group were <b>younger</b> (mean age 59.2 ± 11.6 vs 63.2 ± 10.5 years; p < 0.01), had more <b>smokers </b>(39.1% vs 20.7%; P < 0.01), <b>previous MI</b> (32.6% vs 21.4%; p < 0.01), <b>diabetes mellitus</b> (22.5% vs 14.2%; p = 0.03) and <b>active malignancy</b> (3.6% vs 0.6%; p = 0.01). The angiographic features were well matched between the two groups, apart from less <b>circumflex artery</b> involvement in the ST group (13.0% vs 24.9%; p < 0.01). Factors that differed between the ST cases and controls were <b>use of aspirin</b> on presentation in the ST group (84.1% vs 92.1%; p = 0.01) <b>non-cardiac surgery </b>in the 90 days prior to randomisation (6.5% vs 2.8%; p = 0.04), <b>number of stents</b> inserted (2.2 vs 1.7; p < 0;01), a higher proportion of <b>first generation drug eluting stents</b> (31.9% vs 19.0%; p < 0.01) and of <b>two-stent bifurcation</b> procedures (6.5% vs 2.8%; p = 0.05). <h3>Conclusions</h3> Using a multi-centre approach, we collected multi-source data from patients presenting with coronary ST, along with matched controls. <b>PFT</b>, <b>thrombin generation</b> and <b>OCT</b> data have been analysed to identify important risk factors for ST and these will be presented.