A clinical risk score to identify patients at high risk of very late stent thrombosis |
| |
| Authors: | Thea C Godschalk MSc PhD Marieke E Gimbel MD Wouter W Nolet MD Dionne J van Kessel MD Giovanni Amoroso MD PhD Willem J Dewilde MD PhD Joanna J Wykrzykowska MD PhD Paul W Janssen MD PhD Thomas O Bergmeijer MD Johannes C Kelder MD PhD Ton Heestermans MD PhD Jurriën M ten Berg MD PhD |
| |
| Institution: | 1. Department of Cardiology, St Antonius Hospital, Nieuwegein, the Netherlands;2. Department of Cardiology, OLVG, Amsterdam, the Netherlands;3. Department of Cardiology, Amphia Hospital, Breda, the Netherlands;4. Department of Cardiology, Amsterdam Medical Centre, Amsterdam, the Netherlands;5. Department of Cardiology, Noordwest Hospital Group, Alkmaar, the Netherlands |
| |
| Abstract: | Objectives The aim of this study was to determine predictors of very late stent thrombosis (VLST; >1 year after stenting), and to evaluate whether addition of these predictors to the dual antiplatelet therapy (DAPT) score would improve the ability to identify patients at high risk of VLST who might benefit from DAPT. Background VLST is a severe complication of percutaneous coronary intervention (PCI). Extended knowledge about the predictors of VLST is needed to prevent this life‐threatening complication. Recent data showed a reduction in VLST after treatment with prolonged DAPT. The DAPT study developed a prediction score to identify patients after PCI who might benefit from prolonged DAPT duration. Methods The Dutch stent thrombosis study is a multi‐center case‐control study. Consecutive patients with definite VLST were included between 2007 and 2014. Baseline characteristics from the index PCI were collected. Independent predictors of VLST were identified and added to the DAPT score to develop the VLST score. Results In total, 155 VLST cases and 155 matched controls were included. Suboptimal result of stenting, right coronary artery as target vessel, and diffuse coronary artery ectasia were independent predictors of VLST, and added to the DAPT score. The power of the VLST score to identify patients who experienced VLST was increased (AUC, 95%CI; DAPT score: 0.64, 0.57‐0.70; VLST score: 0.70, 0.63‐0.76, P = 0.010). Conclusions Addition of newly identified independent predictors of VLST resulted in a prediction model with a higher ability to identify patients at high risk of VLST who might benefit from prolonged DAPT. |
| |
| Keywords: | dual antiplatelet therapy prediction model very late stent thrombosis |
|
|
