Incidence, determinants and clinical impact of definite stent thrombosis on mortality in women: From the WIN-DES collaborative patient-level pooled analysis.

Kerkmeijer, Laura S; Claessen, Bimmer E; Baber, Usman; Sartori, Samantha; Chandrasekhar, Jaya; Stefanini, Giulio G; Stone, Gregg W; Steg, P Gabriel; Chieffo, Alaide; Weisz, Giora; Windecker, Stephan; Mikhail, Ghada W; Kastrati, Adnan; Morice, Marie-Claude; Dangas, George D; de Winter, Robbert J; Mehran, Roxana (2018). Incidence, determinants and clinical impact of definite stent thrombosis on mortality in women: From the WIN-DES collaborative patient-level pooled analysis. International journal of cardiology, 263, pp. 24-28. Elsevier 10.1016/j.ijcard.2018.04.047

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BACKGROUND Predictors and clinical outcomes of stent thrombosis (ST) in women have not been well investigated. Present study aimed to identify predictors of definite ST and its impact on mortality in women undergoing percutaneous coronary intervention (PCI). METHODS Patient-level data of women enrolled in 26 randomized trials of DES was pooled. The study population was stratified based on the presence or absence of definite ST. Cox proportional hazards models were used to determine the predictors of definite ST. To analyze the temporal impact of definite ST on mortality Cox regression with ST entered as time-updated covariate was used. RESULTS Of 11,557 patients undergoing PCI with stent implantation, definite ST occurred in 105 patients (0.9%) over median follow-up of 3years. Independent predictors of ST were age (HR 1.03 per year decrease, 95% CI 1.00-1.05; p=0.041), diabetes mellitus (HR 2.25, 95% CI 1.27-3.99; p=0.005), non-ST-segment elevation myocardial infarction (NSTEMI) at presentation (HR 1.97, 95% CI 1.04-3.75; p=0.037) and stent diameter (HR 3.76 per mm decrease, 95% CI 1.66-8.53; p=0.002). Compared to women without ST, the adjusted hazard ratios for mortality in the first 7days, 8-30days, and beyond 30days from ST were 115.81 (95% CI 68.96-194.47); 37.44 (95% CI 17.31-80.98); 3.54 (95% CI 2.20-5.69), respectively. CONCLUSIONS In this large-scale pooled analysis of women, definite ST was uncommon yet associated with substantial mortality risk, which peaked early and rapidly attenuated over time. Younger age, diabetes, NSTEMI and stent diameter were found to be predictors of ST.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Windecker, Stephan

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0167-5273

Publisher:

Elsevier

Language:

English

Submitter:

Nadia Biscozzo

Date Deposited:

21 Feb 2019 14:29

Last Modified:

05 Dec 2019 06:27

Publisher DOI:

10.1016/j.ijcard.2018.04.047

PubMed ID:

29691071

Uncontrolled Keywords:

Predictors Stent thrombosis Women

BORIS DOI:

10.7892/boris.125230

URI:

https://boris.unibe.ch/id/eprint/125230

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