PMID- 16894463
OWN - NLM
STAT- MEDLINE
DCOM- 20070112
LR  - 20070621
IS  - 0340-6245 (Print)
IS  - 0340-6245 (Linking)
VI  - 96
IP  - 2
DP  - 2006 Aug
TI  - Incidence and predictors of subacute thrombosis in patients undergoing primary 
      angioplasty for an acute myocardial infarction.
PG  - 190-5
AB  - Subacute thrombosis (SAT) is a major concern in patients undergoing percutaneous 
      coronary intervention (PCI). So far, only little data has been available on 
      characteristics and outcome of patients with SAT after primary PCI for ST 
      elevation myocardial infarction (STEMI). From 1997-2001, 1,548 unselected 
      consecutive patients underwent primary PCI for STEMI as part of a randomized 
      controlled trial stenting vs. balloon angioplasty. All patients received 
      acetylsalicylic acid (500 mg i.v.) and heparin (5,000 IU) before the procedure. 
      After stenting, all patients received ticlopidine 250 mg daily (before July 1999) 
      or clopidogrel 75 mg daily (after July 1999) for one month. Five percent of 
      patients received glycoprotein IIb/IIIa blockers. We prospectively recorded 
      incidence and characteristics of patients with SAT during one year follow-up. SAT 
      occurred in 4.1% (63/1548) and reinfarction in 6.0% of patients. The incidence of 
      SAT did not change over time (1997: 8/175[4.6%],1998: 8/325 [2.5%],1999: 13/358 
      [3.6%], 2000: 22/426 [5.2%], 2001: 12/264 [4.5%]). SAT occurred in 39/63(62%) 
      patients during hospital stay. The incidence did not differ between patients 
      after ticlopidine 23/681 (3.4%) or clopidogrel 40/867 (4.6%, p = 0.222). 
      Univariate predictors of SAT were: patients with an LAD stenosis (5.4% vs. 2.9%, 
      p = 0.016), with Killip class >1 at presentation (8.6% vs. 3.7%, p = 0.007) and 
      in patients who received a stent (5.1% vs. 2.7%, p = 0.022). After multivariate 
      analysis, Killip class >1 on admission was the only independent predictor of 
      SAT(OR 2.26, 95% CI 1.14-4.47, p = 0.019). SAT was associated with a higher 
      mortality at long-term follow-up (15% vs. 7%, p = 0.026). In a prospectively 
      recorded, unselected consecutive series of patients undergoing PCI for STEMI, SAT 
      occurred in 4.1% of patients at one-year follow-up. Signs of heart failure on 
      admission, anterior myocardial infarction and stenting were predictors of SAT.
FAU - Smit, Jaap Jan J
AU  - Smit JJ
AD  - Department of Cardiology, Isala Klinieken, Zwolle, The Netherlands.
FAU - van 't Hof, Arnoud W J
AU  - van 't Hof AW
FAU - de Boer, Menko Jan
AU  - de Boer MJ
FAU - Hoorntje, Jan C A
AU  - Hoorntje JC
FAU - Dambrink, Jan Henk E
AU  - Dambrink JH
FAU - Gosselink, A T Marcel
AU  - Gosselink AT
FAU - Ottervanger, Jan Paul
AU  - Ottervanger JP
FAU - Kolkman, J J Evelien
AU  - Kolkman JJ
FAU - Suryapranata, Harry
AU  - Suryapranata H
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - Germany
TA  - Thromb Haemost
JT  - Thrombosis and haemostasis
JID - 7608063
SB  - IM
MH  - Acute Disease
MH  - Aged
MH  - Angiography/*methods
MH  - Angioplasty, Balloon/*methods
MH  - Catheterization
MH  - Disease-Free Survival
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/*complications/epidemiology/*surgery
MH  - Prognosis
MH  - Stents
MH  - Thrombosis/*complications/*diagnosis/epidemiology
MH  - Time Factors
EDAT- 2006/08/09 09:00
MHDA- 2007/01/16 09:00
CRDT- 2006/08/09 09:00
PHST- 2006/08/09 09:00 [pubmed]
PHST- 2007/01/16 09:00 [medline]
PHST- 2006/08/09 09:00 [entrez]
AID - 06080190 [pii]
PST - ppublish
SO  - Thromb Haemost. 2006 Aug;96(2):190-5.