Predictor of stent thrombosis in patients treated with turbostratic carbon-coated stent implantation for acute myocardial infarction.

BACKGROUND

Stent thrombosis is a major complication after percutaneous coronary intervention (PCI) for ST-segment elevation acute myocardial infarction (AMI) and is associated with reinfarction and increased risk of death.

METHODS

Patients treated with the turbostratic carbon-coated stent (CID, Saluggia, Italy) for AMI were identified from a prospective primary PCI database. Primary end-point was stent thrombosis within 6 months. Forward stepwise Cox proportional hazards analysis was used to identify independent predictors of stent thrombosis.

RESULTS

Between 2001 and 2008, 746 patients underwent turbostratic carbon-coated stent implantation for AMI. Patients had a mean age of 65 ± 12 years, 9% had cardiogenic shock on admission, 48% had multivessel coronary disease, 78% had baseline target vessel TIMI grade 0-1. Multiple stent implantation was performed in 26% of patients. The majority of patients (78%) received abciximab treatment and a postprocedural TIMI grade 3 flow was achieved in 98% patients. Definite stent thrombosis occurred in 10 patients (1.3%), while three patients (0.4%) had possible stent thrombosis. No probable stent thrombosis occurred. There were no procedural stent thromboses. In patients who received abciximab stent thrombosis the rate was 1%, while it was 4.3% in patients not receiving abciximab treatment. After adjusting for all clinical, angiographic, and procedural variables, abciximab treatment (HR 0.17; 95% CI 0.05-0.56, P = 0.003) and major bleedings (HR 14.2; 85% CI 2.79-72.44, P = 0.001) were the only two predictors related to stent thrombosis.

CONCLUSIONS

Patients with AMI treated with turbostratic carbon-coated stent implantation and abciximab treatment have a low incidence of stent thrombosis. Abciximab treatment along with major bleeding complications are the only predictors related to stent thrombosis.