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Stent thrombosis increases the risk of death by 10 times

2017-08-05

ADAPT-DES studies have shown that early stent thrombosis may be the most fatal complication of ischemic and bleeding events after implantation of drug-coated stents (DES). (JACC Cardiovasc Interv., June 22nd online) study showed that 2-year all-cause mortality in patients with stent thrombosis was more than 10-fold higher than that of the non-event population, 27.2% and 2.7% (HR = 11.37), respectively. The mortality rate was 38.5% in patients with early stent thrombosis (especially within 30 days).But the early stent thrombosis and death more closely related to the reasons it is difficult to draw conclusions. The secondary cause of DES implantation was advanced myocardial infarction (1 year after myocardial infarction, 7.5%) and advanced bleeding (1 month to 1 year, 7.3%). The same period of review shows that very late stent thrombosis-related 30-day mortality (20%) is almost primary myocardial infarction or clinical bleeding-related mortality rate of 3 times. Therefore, the key to the safety of percutaneous coronary intervention is to optimize the duration of double antiplatelet therapy (DAPT). Patients with high risk of thrombosis in the stent can prolong DAPT treatment, while bleeding at high risk should limit DAPT treatment. The study included 8582 subjects, 12.4% of which occurred after implantation of DES.

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