Patient-Related Factors Predicting Stent Thrombosis in Percutaneous Coronary Interventions

• Published in: Journal of clinical medicine Vol. 12; no. 23; p. 7367
• Main Authors: Anghel, Larisa, Tudurachi, Bogdan-Sorin, Tudurachi, Andreea, Zăvoi, Alexandra, Clement, Alexandra, Roungos, Alexandros, Benchea, Laura-Cătălina, Zota, Ioana Mădălina, Prisacariu, Cristina, Sascău, Radu Andy, Stătescu, Cristian
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 28.11.2023
• Subjects: Acute coronary syndromes; Aspirin; Blood clot; Cardiovascular disease; Clopidogrel; Complications; Complications and side effects; Coronary artery bypass; Coronary vessels; Development and progression; Diabetes; Drug-eluting stents; Heart attack; Heart attacks; Ischemia; Medical research; Medicine, Experimental; Mortality; Patient compliance; Patients; Risk factors; Stent (Surgery); Stents; Stroke; Surgery; Thrombosis; Ticagrelor; Transluminal angioplasty; Vein & artery diseases; Romania; France; patient-related factors; percutaneous coronary intervention; heart attack; cardiac death; stent thrombosis
• ISSN: 2077-0383; 2077-0383
• DOI: 10.3390/jcm12237367

Over the past four decades, percutaneous coronary intervention (PCI) safety and efficacy have significantly improved, particularly with the advent of the drug-eluting stent (DES). First-generation DESs reduced in-stent restenosis rates and targeted lesion revascularization; however, safety issues emerged, due to high incidences of stent thrombosis (ST) linked to death, myocardial infarction, and repeat revascularization. Second-generation DESs were developed to overcome these issues, reducing late-thrombotic-event risk while maintaining anti-restenosis efficacy. Nevertheless, ST still occurs with second-generation DES use. Stent thrombosis etiology is multifaceted, encompassing lesion-, patient-, procedural-, and stent-related factors. Overall, most early-stent-thrombosis cases are linked to procedural and patient-related aspects. Factors like premature discontinuation of dual antiplatelet therapy, resistance to clopidogrel, smoking, diabetes mellitus, malignancy, reduced ejection fraction or undertaking coronary angioplasty for an acute coronary syndrome can increase the risk of stent thrombosis. The aim of this study is to assess patient-related factors that potentially heighten the risk of stent thrombosis, with the objective of pinpointing and addressing modifiable contributors to this risk. By focusing on both patient- and procedure-related factors, a multifaceted approach to coronary revascularization can help minimize complications and maximize long-term benefits in managing ST.