Clinical, angiographic, and intravascular ultrasound predictors of early stent thrombosis in patients with acute myocardial infarction

摘要

Risk factors reported for early stent thrombosis (EST) included acute coronary syndrome, suboptimal antiplatelet therapy, procedural factors such as residual dissection and underexpansion of stents, and smaller final lumen area and inflow/outflow disease (residual stenosis or dissection) by intravascular ultrasound (IVUS) [1-4]. However, the predictors of EST including all variables such as baseline characteristics, laboratory data, angiographic and 1VUS findings in patients with acute myocardial infarction (AMI) are still not well known. From January 2007 to December 2009, we identified 418 consecutive patients with a first AMI who underwent pre-percutaneous coronary intervention (PCI) 1VUS within 24 h from symptom onset, were stented successfully, and had post-PCI IVUS imaging. EST included acute (<24 h) and subacute ST (1 to 30 days) after stent implantation. Cardiac-specific troponin I (cTnl) levels were measured by a paramagnetic particle, chemiluminescent immunoenzymatic assay (Beck-man, Coulter Inc., Fullerton, California). No-reflow was defined as post-PCI TIMI grade 0,1, or 2 flow. Tissue prolapse was defined as tissue extrusion through the stent strut at post-PCI.