Comparison of Short- and Long-Term Cardiac Mortality in Early Versus Late Stent Thrombosis (from Pooled PROTECT Trials)

Studies have indicated varying mortality risks with timing of stent thrombosis (ST), but few have been adequately powered with prospective late follow-up. PROTECT randomized 8,709 subjects to either Endeavor zotarolimus-eluting or Cypher sirolimus-eluting stents. PROTECT Continued Access enrolled 1,...

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Bibliographic Details
Published in:The American journal of cardiology 2015-06, Vol.115 (12), p.1678-1684
Main Authors: Secemsky, Eric A., MD, Matteau, Alexis, MD, MSc, Yeh, Robert W., MD, MBA, Steg, Philippe Gabriel, MD, Camenzind, Edoardo, MD, Wijns, William, MD, McFadden, Eugene, MD, Mauri, Laura, MD, MSc
Format: Article
Language:English
Subjects:
Aged
Cardiology
Cardiovascular
Cause of Death
Clinical outcomes
Coronary Restenosis - mortality
Coronary Restenosis - prevention & control
Coronary Thrombosis - mortality
Drug-Eluting Stents
Female
Follow-Up Studies
Graft Occlusion, Vascular - mortality
Graft Occlusion, Vascular - prevention & control
Heart attacks
Humans
Immunosuppressive Agents - administration & dosage
Male
Middle Aged
Mortality
Platelet Aggregation Inhibitors - administration & dosage
Prospective Studies
Risk Factors
Sirolimus - administration & dosage
Sirolimus - analogs & derivatives
Stents
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Summary:Studies have indicated varying mortality risks with timing of stent thrombosis (ST), but few have been adequately powered with prospective late follow-up. PROTECT randomized 8,709 subjects to either Endeavor zotarolimus-eluting or Cypher sirolimus-eluting stents. PROTECT Continued Access enrolled 1,018 patients treated with Endeavor zotarolimus-eluting stents. Subjects completed at least 4 and 3 years of follow-up, respectively. ARC-defined definite and probable ST events were stratified by time from index procedure: early (≤30 days), late (>30 and ≤360 days), and very late (>360 days). Rates of death and myocardial infarction were analyzed by ST timing. Median follow-up was 4.1 years. There were 184 ST events (1.9%): 61 early, 27 late, and 96 very late. Patient and procedural characteristics were similar between timing groups. There was no difference in dual-antiplatelet therapy use at discharge (97%) or 1 year (84%). Cardiac death in patients with ST at 4 years occurred in 32.1% compared with 2.5% in patients without ST (p
ISSN:0002-9149
1879-1913
DOI:10.1016/j.amjcard.2015.03.010