Correlates and long-term outcomes of angiographically proven stent thrombosis with sirolimus- and paclitaxel-eluting stents

Pramod K. Kuchulakanti, William W. Chu, Rebecca Torguson, Patrick Ohlmann, Seung Woon Rha, Leonardo C. Clavijo, Sang Wook Kim, Ahn Bui, Natalie Gevorkian, Zhenyi Xue, Kimberly Smith, Jana Fournadjieva, William O. Suddath, Lowell F. Satler, Augusto D. Pichard, Kenneth M. Kent, Ron Waksman

Research output: Contribution to journalArticlepeer-review

622 Citations (Scopus)


Background - Stent thrombosis (ST) is a serious complication of drug-eluting stent (DES) implantation regardless of the timing (acute, subacute, or late). The correlates of ST with DES are not yet completely elucidated. Methods and Results - From a total cohort of 2974 consecutive patients treated with DES since April 2003, we identified 38 patients who presented with angiographic evidence of ST (1.27%). The ST occurred acutely in 5 patients, subacutely (s30 days) in 25 patients, and late (>30 days) in 8 patients. The clinical, angiographie, and procedural variables of these patients were compared with the remaining 2936 consecutive patients who underwent DES implantation and did not experience ST during a follow-up of 12 months. Logistic regression analysis was conducted to determine the correlates of ST. Compared with patients without ST, patients with ST had a higher frequency of diabetes, acute postprocedural renal failure, and chronic renal failure. There were more bifurcation lesions, type C lesions, and a trend for smaller-diameter stents. Discontinuation of clopidogrel was higher in these patients (36.8% versus 10.7%; P<0.0001). The mean duration to ST from the stent implantation was 8.9±8.5 days in subacute and 152.7±100.4 days in late thrombosis cases. Mortality was significantly higher in patients with ST compared with those without ST at 6 months (31% versus 3%; P<0.001). Multivariate analysis detected cessation of clopidogrel therapy, renal failure, bifurcation lesions, and in-stent restenosis as significant correlates of ST (P<0.05). Conclusions - ST continues to be a serious complication of contemporary DES use. Careful management is warranted in patients with renal failure and in those undergoing treatment for in-stent restenosis and bifurcations. Special focus on clopidogrel compliance may minimize the incidence of ST after DES implantation.

Original languageEnglish
Pages (from-to)1108-1113
Number of pages6
Issue number8
Publication statusPublished - 2006 Feb
Externally publishedYes


  • Angioplasty
  • Clopidogrel
  • Stents
  • Thrombosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)


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