Stent thrombosis following 2 drug-eluting stent implantations for coronary bifurcation lesion: a single-center analysis

Abstract

Background: The incidence of stent thrombosis (ST) following 2 drug-eluting stent (DES) implantations for coronary bifurcation lesions needs to be identified.

Methods: From April 2004 to April 2009, 705 consecutive patients with true bifurcation lesions who underwent a double stenting procedure with DES at the Fu Wai Hospital were analyzed.

Results: Six (0.85%) patients had a definite ST, all of them had an early (4 acute and 2 subacute) definite ST. Probable ST occurred in 4 patients; in all of these cases, the event occurred early and was adjudicated because of the occurrence of sudden death within 30 days of the procedure. Therefore, a total of 10/705 (1.42%) patients had a definite or probable ST. Possible stent thrombosis was adjudicated only in 1 patient 371 days after the initial PCI in whom the cause of death was unexplained. Compared to the patients without definite and probable ST, patients with definite and probable ST were older, had more unstable angina, lower LVEF, and more left main bifurcation lesions (63.2 +/- 8.9 vs. 56.8 +/- 10.9 yrs; P = 0.049, 100% vs. 64.7%; P = 0.018, 50.6 +/- 9.9 vs. 60.3 +/- 12.4%; P = 0.019 and 70.0% vs. 36.1%; P = 0.043). Logistic analysis results indicated that only LVEF (OR 0.92, 95% CI 0.87-0.93; P = 0.017) was associated with definite and probable ST.

Conclusions: The present study indicates that modern 2-DES technique for bifurcation lesions was comparatively safe with a low incidence of ST.