Drug-Eluting Stent Thrombosis During Perioperative Period

DOI Web Site 被引用文献2件 参考文献21件
  • Rhee Sang Jae
    Department of Cardiovascular Medicine, The Heart Center of Wonkwang University Hospital
  • Lee Sang Rok
    Department of Cardiovascular Medicine, Chonbuk National University Hospital
  • Yun Kyeong Ho
    Department of Cardiovascular Medicine, The Heart Center of Wonkwang University Hospital
  • Nam Chang-Wook
    Department of Cardiovascular Medicine, Keimyung University Hospital
  • Jun Dong-Hwan
    Department of Cardiovascular Medicine, Keimyung University Hospital
  • Chae Jei-Keon
    Department of Cardiovascular Medicine, Chonbuk National University Hospital
  • Jeong Jin-Won
    Department of Cardiovascular Medicine, The Heart Center of Wonkwang University Hospital

書誌事項

公開日
2008
DOI
  • 10.1536/ihj.49.135
公開者
一般社団法人 インターナショナル・ハート・ジャーナル刊行会

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説明

Recently, the number of patients in whom a drug-eluting stent (DES) has recently been implanted and who need to undergo surgery or the most invasive procedure is increasing. However, there are limited data about the risk of perioperative thrombosis of DES. We evaluated the incidence and the risk factors of DES thrombosis during the perioperative period.<br> Between January 2002 and December 2006, 141 patients who underwent surgery requiring discontinuation of a dual antiplatelet agent within 12 months of DES implantation were enrolled in one of the 3 study hospitals. We reviewed the clinical and procedural characteristics of the patients who developed stent thrombosis during the perioperative period.<br> Stent thrombosis occurred in 7 cases (5.0%). The clinical outcomes of the patients with stent thrombosis were death in 5 cases and nonfatal MI in 2 cases. The patients with stent thrombosis were found to be older (64.2 ± 9.7 versus 71.7 ± 6.0 years, P = 0.045), to use a Taxus stent more frequently (36.6 versus 85.7%, P = 0.014), and to have a more prolonged period of discontinuation of clopidogrel (12.7 ± 10.0 versus 51.3 ± 33.2 days, P = 0.022) than the patients without stent thrombosis. Multivariate analysis revealed that 7 days or longer discontinuation of clopidogrel (OR 12.8, 95% CI 1.3-121.6, P = 0.021) and the use of a Taxus stent (OR 10.2, 95% CI 1.1-95.7, P = 0.043) were significant independent predictors of stent thrombosis during the perioperative period.<br> A prolonged period of discontinuation of clopidogrel was associated with higher risk of stent thrombosis during the perioperative period. An earnest effort to continue antiplatelet therapy throughout the perioperative period can minimize the risk of stent thrombosis. <br>

収録刊行物

  • International Heart Journal

    International Heart Journal 49 (2), 135-142, 2008

    一般社団法人 インターナショナル・ハート・ジャーナル刊行会

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