Grant/Research Support


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Grant/Research Support

  • Grant/Research Support

  • Consulting Fees/Honoraria



Acute and subacute DES thrombosis are the most devastating complication of coronary stent implantation

  • Acute and subacute DES thrombosis are the most devastating complication of coronary stent implantation

  • Late DES thrombosis is a relatively new and poorly studied phenomenon

  • Cohort-based analyses require years of follow-up, and very large numbers of patients



Most have not included angiographic and procedural data

  • Most have not included angiographic and procedural data

  • Limited number of stent thrombosis events (frequency of 2% or less):

    • Ability to assess only very strong correlates
    • Wide confidence intervals around risk estimates
    • A study of 5000 patients would only have approximately 100 events, with ability to reliably assess 5-10 predictors


To describe the correlates (clinical, procedural, and angiographic) of late (FDA approved) DES thrombosis (>30 days from stent implantation) using an adequately sized and powered case-control study design

  • To describe the correlates (clinical, procedural, and angiographic) of late (FDA approved) DES thrombosis (>30 days from stent implantation) using an adequately sized and powered case-control study design

    • 500 total late Stent thrombosis events
  • To describe the outcomes of patients with stent thrombosis in the DES era







































Prevalence of Late and Very Late DES ST cannot be assessed

  • Prevalence of Late and Very Late DES ST cannot be assessed

  • In DESERT 90% of the patients in both groups had first generation DES

  • This analysis only identifies patients who survived the acute event of ST and presented for an angiogram

  • Angiographic data is currently being analyzed



DESERT is the largest case-control registry of late and very late DES Stent Thrombosis

  • DESERT is the largest case-control registry of late and very late DES Stent Thrombosis

  • In DESERT, the majority of the Late ST occurred after one year (~75%) and continued to occur up to 7.3 years

  • The clinical presentation of late ST was mainly MI (66.9% STEMI and 22% NSTEMI)

  • Nearly 30% of the patients with L ate ST were on DAPT at the time of the event

  • In hospital mortality of patients who presented with late ST was 3.8% and 1.67% at one year



Patients who had first generation DES continue to be at risk for late stent thrombosis up to 7 years

    • Patients who had first generation DES continue to be at risk for late stent thrombosis up to 7 years
    • Younger patients, smokers, black ethnicity, patients with multi vessel disease, STEMI, or SVG lesions are at higher risk of developing late ST and should be reconsider for DES, or for a potent or longer DAPT regimen
    • Mortality with late ST is lower when compared with historically reported acute and subacute ST. This suggest a different pathological mechanism for late ST: (late restenosis and/or neo-atherosclerosis)





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