Stent thrombosis is a major concern in clinical practice: A single Saudi center experience

Background: Drug-eluting stents (DES) are used in the majority of patients who undergo percutaneous coronary intervention (PCI), and have reduced the rate of in-stent restenosis and repeated revascularization in comparison to bare metal stents. However, stent thrombosis (ST) is an uncommon but serious complication of coronary artery stents that is mostly fatal or presents as a large non-fatal myocardial infarction (MI), usually with ST elevation. Objective: To study the incidence of stent thrombosis in Middle Eastern Saudi patients who underwent PCI using both drug-eluting stents (DES) and bare metal stents (BMS). ST can occur acutely (within 24 h), sub acutely (within 30 days), or as late as one year (late) or even more than one year (very late). Methods: In an observational, single center study in catheterization (cath) lab a total of 1386 patients underwent PCI between January 2008 and September 2010. The study included all patients in that period who had acute coronary syndrome and stable coronary artery disease (CAD). Results: A total of 1386 patients had PCI and stent deployments; 19 (1.3%) patients had stent thrombosis, four patients (21%) received BMS and 15 patients (79%) received DES. Four patients had acute ST; five had subacute ST; eight patients had late ST; while two patients had very late ST. Nine patients (47%) had DM and eight patients (42%) had hypertension. Conclusion: The incidence of ST in Saudi patients who received DES at our center is similar to internationally reported numbers. Almost half of ST patients are diabetics and there is increasing concern that the risk for late stent thrombosis is slightly higher with DES than BMS. (C) 2013 Production and hosting by Elsevier B.V. on behalf of King Saud University.