Does the timing of stent thrombosis affect outcomes?

This paper compared the long term and short term heart-related mortality rates in early versus late stent thrombosis. 

A stent is placed in a blocked blood vessel to allow blood flow to be smooth. Stent thrombosis occurs when the stent causes blood to clot, blocking the vessel. It is thought that the time stent thrombosis occurs is associated with different outcomes in patients. 

The current study compared the outcomes between patients who experienced a stent thrombosis soon after the stent was placed to those who experienced thrombosis long afterwards.

9370 patients with drug-eluting stents (stent that releases medication) were followed-up for an average 4.1 years. 1.9% of patients had stent thrombosis. Patients with stent thrombosis were more likely to have diabetes mellitus, history of smoking, previous heart attack and previous stroke.

0.6% of patients had an early stent thrombosis, occurring an average 5 days after procedure. 0.3% of patients had a late stent thrombosis, after an average 151 days. 1% of patients had a very late stent thrombosis, which was after an average of 1018 days.

After 4 years of follow-up, 32.1% of patients with stent thrombosis and 2.5% of patients without stent thrombosis had a cardiac death (death caused by the heart not functioning well). Cardiac death at 4 years occurred more often in patients with early stent thrombosis (50.8%) compared with late (18.5%) and very late (24%) stent thrombosis. Cardiac death occurring the same day as the stent thrombosis was more common in patients with early stent thrombosis. Cardiac death associated with late and very late stent thrombosis occurred more commonly days after the thrombosis.

Heart attacks occurred in 93.5% of patients with stent thrombosis and in 14.3% of patients without stent thrombosis. Late and very late stent thrombosis were more often associated with heart attack compared with early stent thrombosis. 

The authors concluded that cardiac death was more common after early stent thrombosis than later stent thrombosis. 

Talk to your doctor about ways to reduce stent thrombosis.