Predictors of Sub-Acute Stent Thrombosis in Acute Myocardial Infarction Patients Following Primary Coronary Stenting With Bare Metal Stent

• Published in: Circulation Journal Vol. 70; no. 2; pp. 151 - 155
• Main Authors: Katayama, Toshiro, Nakashima, Hiroshi, Takagi, Chisa, Honda, Yukiharu, Suzuki, Shin, Iwasaki, Yoshihiro, Yamamoto, Tadashi, Yoshioka, Masato, Yano, Katsusuke
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Circulation Society 2006
• Subjects: Acute Disease; Aged; Biomarkers - analysis; C-reactive protein; C-Reactive Protein - analysis; Female; Humans; Male; Middle Aged; Myocardial infarction; Myocardial Infarction - blood; Myocardial Infarction - complications; Myocardial Infarction - therapy; Predictive Value of Tests; Risk Factors; Serum Amyloid A Protein - analysis; Serum amyloid-A protein; Stents - adverse effects; Sub-acute stent thrombosis; Thrombosis - blood; Thrombosis - etiology
• ISSN: 1346-9843; 1347-4820
• DOI: 10.1253/circj.70.151

Background The aim of the present study was to identify the relationship between sub-acute stent thrombosis (SAT) and acute-phase inflammatory reactants, such as high-sensitivity C-reactive protein (hs-CRP) and serum amyloid-A protein (SAA), in patients with acute myocardial infarction (AMI) successfully treated with primary coronary stenting. Methods and Results The 381 consecutive AMI subjects were reperfused by primary coronary stenting within 24 h of onset. SAT was confirmed angiographically in 10 patients (2.6%). There were no significant differences between the patients with or without SAT in terms of patient characteristics, Killip classification on admission, or stent diameter, nor were there significant differences between the 2 groups in terms of left ventricular function soon after stenting (left ventricular ejection fraction) or end-diastolic volume index. The plasma levels of both hs-CRP and SAA were significantly higher in the SAT patients than in the others (hs-CRP: 6.7±6.7 mg/dl vs 3.3±3.8 mg/dl, p=0.007; SAA: 699±812 μg/dl vs 208±273 μg/dl, p<0.0001). Multivariate analysis identified SAA as an independent predictor of SAT (risk ratio: 4.9, 95% confidence interval: 1.7-14.9, p<0.05). Conclusion In patients with AMI who are treated with primary coronary stenting, inflammation may be closely related to SAT, for which SAA is a useful predictor. (Circ J 2006; 70: 151 - 155)