Contemporary occurrence of stent thrombosis in clinical practice: Better never than late

摘要

Stent thrombosis (ST) at any time following percutaneous coronary intervention (PCI) is an uncommon yet life-threatening event. The true frequency of ST, particularly beyond the early weeks to months postprocedure, has been challenging to accurately quantify for a variety of reasons [1]. After the proposal and adoption of a series of formal definitions by the Academic Research Consortium (ARC) in 2007 [2], data emerged reporting frequencies of - 1% for subacute ST, 0.5% for late ST, and 0.2-0.5% per year, thereafter, for very late ST (VLST) [3,4]. Independent risk factors for ST that have consistently emerged include early discontinuation of dual antiplatelet therapy (DAPT), complexity of the original PCI, and some underlying comorbidities, such as renal failure and diabetes mellitus. The reported consequences of ST are devastating with pooled data from several studies showing a composite mortality and non-fatal myocardial infarction rate of 60-80% at the time of ST or during the first week after the event [5,6]. Information regarding outcomes of ST with modern day percutaneous treatment strategies is limited.