Predictors of coronary stent thrombosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Associate Editor-in-Chief: Smita Kohli, M.D.

Overview

A number of clinical, angiographic, and procedural factors predispose to the occurrence of stent thrombosis. Predictors of stent thrombosis can be classified into anatomic variables, procedure related variables and clinical variables. A new entity which has been recently recognised and is being increasingly studied in relation to stent thrombosis is hyporesponsiveness to antiplatelet agents.

Procedure related variables

Procedure related variables include stent underexpansion, margin dissections, incomplete wall apposition, residual inflow and outflow disease, overlapping stent, polymer materials.

Anatomic variables

Lesion-specific factors that increase the likelihood of stent thrombosis include a residual dissection at the margin of the stent, impaired flow into or out of the stent, small stent diameters (<3 mm), long stent lengths, and treatment of an acute myocardial infarction.

Clinical variables

Clinical variables include acute myocardial infarction, clopidogrel noncompliance and discontinuation, hyporesponsiveness to antiplatelet agents, diabetes mellitus, renal failure, congestive heart failure, prior radiation brachytherapy.