Predictors of Coronary Stent Thrombosis: The Dutch Stent Thrombosis Registry

Objectives This study sought to comprehensively identify predictors of stent thrombosis (ST). Background Given the devastating consequences of ST, efforts should be directed toward risk stratification to identify patients at highest risk for ST. Methods Consecutive patients with angiographic ST were enrolled. Patients who did not suffer from a ST were randomly selected in a 2:1 ratio and were matched for: 1) percutaneous coronary intervention (PCI) indication; 2) same date of index PCI; and 3) same interventional center. Results Of 21,009 patients treated with either a bare-metal or drug-eluting stent, 437 patients (2.1%) presented with a definite ST. A total of 140 STs were acute, 180 were subacute, 58 were late, and 59 were very late. Undersizing of the coronary stent, Thrombolysis In Myocardial Infarction flow grade Conclusions Important correlates of ST were identified. Discontinuation of clopidogrel, undersizing of the coronary stent, present malignancy, and intermediate (≥50% to