1 The Faculty of Medicine, Aalborg University, VBN2 Aalborg University Hospital, The Faculty of Medicine, Aalborg University, VBN3 Klinik Hjerte-Lunge, The Faculty of Medicine, Aalborg University, VBN4 Hjertemedicin (Kardiologi), The Faculty of Medicine, Aalborg University, VBN5 Department of Cardiology, Copenhagen University Hospital Roskilde, Roskilde, Denmark.6 Department of Medicine, Aarhus University Hospital Herning, Herning, Denmark.7 The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.8 Department of Cardiology, Odense Universy Hospital, Odense, Denmark.9 Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, Denmark.10 Department of Cardiology, Bispebjerg University Hospital, Copenhagen, Denmark.11 Department of Medicine, Copenhagen University Hospital Glostrup, Glostrup, Denmark.
A Five Year Follow-Up of the SORT OUT II Study
Background: The widespread use of coronary stents has exposed a growing population to the risk of stent thrombosis, but the importance in terms of risk of ST-segment elevation myocardial infarctions (STEMIs) remains unclear. Methods: We studied five years follow-up data for 2,098 all-comer patients treated with coronary stents in the randomized SORT OUT II trial (mean age 63.6 yrs. 74.8% men). Patients who following stent implantation were readmitted with STEMI were included and each patient was categorized ranging from definite-to ruled-out stent thrombosis according to the Academic Research Consortium definitions. Multivariate logistic regression was performed on selected covariates to assess odds ratios (ORs) for definite stent thrombosis. Results: 85 patients (4.1%), mean age 62.7 years, 77.1% men, were admitted with a total of 96 STEMIs, of whom 60 (62.5%) had definite stent thrombosis. Notably, definite stent thrombosis was more frequent in female than male STEMI patients (81.8% vs. 56.8%, p=0.09), and in very late STEMIs (p=0.06). Female sex (OR 3.53 [1.01-12.59]) and clopidogrel (OR 4.43 [1.03-19.01]) was associated with increased for definite stent thrombosis, whereas age, time since stent implantation, use of statins, initial PCI urgency (STEMI [primary PCI], NSTEMI/unstable angina [subacute PCI] or stable angina [elective PCI]), and glucose-lowering agents did not seem to influence risk of stent thrombosis. Conclusion: In a contemporary cohort of coronary stented patients, stent thrombosis was evident in more than 60% of subsequent STEMIs.