Predictors of Stent Thrombosis in Patients With ST-Elevation Acute Coronary Syndrome Subjected to Primary Coronary Artery Intervention

Basing on complex evaluation of clinical, angiographic, and laboratory data we revealed predictors of stent thrombosis in patients with ST-elevation acute coronary syndrome (ACS) subjected to percutaneous coronary interventions (PCI). Among studied sample of patients (n=124) we distinguished a group of patients with proven stent thrombosis at various stages of follow-up (n=22, group 1) and a group of patients with favorable outcome (n=102, group 2). Unifactorial analysis revealed unfavorable prognostic influence (p=0.025) of hemodynamically significant stenosis of proximal segment of anterior distending artery, disturbances of rhythm and conduction (p=0.0002), as well as degree of heart failure (HF) according to Killip on day 1 of development of symptoms of ACS, and also of high selectin P level on day 10 (p=0.031). With the aim of assessment of prognostic significance of revealed factors we conducted stepwise discriminant analysis according to results of which most significant parameter affecting development of stent thrombosis in patients with ST-elevation ACS appeared to be high Killip class of HF (p<0.0003), to a lesser degree - elevated level of sP-selectin on day 10 of observation (p=0.005). Parameter for which prognostic significance was not revealed as a result of multifactorial analysis was lesion in proximal segment of anterior descending artery (p=0.496). Probability of correct classification of the model was 88.7% at p<0.0001.