020 Coronary stent thrombosis of drug eluting stent in daily clinical practice: analysis of a tertiary single center registry

The large reduction in restenosis rates with drug-eluting stents (DES), compared with bare-metal stents (BMS), has already been demonstrated. In those studies this gain was not associated with safety concerns such as excess early and late stent thrombosis (ST). We tried to determine predictive factors of drug eluting instent thrombosis in a tertiary center. Our study is retrospective enrolling 619 patients who underwent drug eluting stenting. Thrombosis definition was based on the Academic Research Consortium (ACR 2008), We compared 2 groups T+ (thrombosis) et T-(no thrombosis). The rate of thrombosis was 3,7% (23 patients among 619). This complication occurred at a mean follow-up of 21,43 days. There were one case of acute thrombosis, 21 cases of subacute Thrombosis, one case of late thrombosis. No very late thrombosis was noted. Patients who had thrombosis were older (T+ = 67years old; T− = 63,16 years old), more diabetic (T+ = 65%; T− = 61,5%) but without significant difference. The occurring of stent thrombosis didn’t depend on the site nor on the technic of implantation. There was no correlation between this complication and stent sizes despite that it seems to be more frequent in the case of longer stents (T+ = 24,32; T− = 22,13; p = 0,47) and in the case of small diameter (T+ = 2,82; T− = 2,94; p = 0,36). Predictive factors of stent thrombosis were clopidogrel withdrawal for surgery (T+ = 43,47%; T− = 27,51%; p = 0,09), the early withdrawal of clopidogrel (T+ = 13,99 mois; T− = 9,08 mois; p = 0,02). Stent thrombosis was associated to the increase of major cardiovascular events (T+ = 39,13%; T = 9,7%; p  Instent thrombosis is a lifethreatening complication occurring in 0 to 3,5% based on randomized studies. It is more frequent in case of drug eluting stenting.