Incidence and Clinical Features of Early Stent Thrombosis in the Era of New P2y12 Inhibitors (PLATIS-2)

Early stent thrombosis (EST) (≤ 30 days after stent implantation) is a relatively rare but deleterious complication of percutaneous coronary intervention (PCI). Administration of newer P2Y12 inhibitors (prasugrel and ticagrelor) combined with aspirin has been shown to reduce the incidence of sub-acu...

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Bibliographic Details
Published in:PloS one 2016, Vol.11 (6), p.e0157437-e0157437
Main Authors: Asher, Elad, Abu-Much, Arsalan, Goldenberg, Ilan, Segev, Amit, Sabbag, Avi, Mazin, Israel, Shlezinger, Meital, Atar, Shaul, Zahger, Doron, Polak, Arthur, Beigel, Roy, Matetzky, Shlomi
Format: Article
Language:English
Subjects:
Acute Coronary Syndrome - etiology
Acute Coronary Syndrome - mortality
Acute coronary syndromes
Adenosine - analogs & derivatives
Adenosine - therapeutic use
Aged
Aspirin
Aspirin - therapeutic use
Biomarkers
Blood platelets
Cardiology
Cardiovascular disease
Clopidogrel
Coronary vessels
Early Diagnosis
Female
Heart attacks
Heart diseases
Hospitalization
Hospitals
Humans
Implantation
Implants
Incidence
Inhibitors
Intervention
Israel
Male
Medical imaging
Medicine
Medicine and Health Sciences
Middle Aged
Mortality
Multivariate Analysis
Patients
Percutaneous Coronary Intervention - adverse effects
Prasugrel Hydrochloride - therapeutic use
Purinergic P2Y Receptor Antagonists - therapeutic use
Receptors, Purinergic P2Y12 - metabolism
Registries
Regression analysis
Stents
Stents - adverse effects
Stroke
Stroke - etiology
Stroke - mortality
Studies
Surgical implants
Survival Analysis
Thromboembolism
Thrombosis
Thrombosis - diagnosis
Thrombosis - drug therapy
Thrombosis - etiology
Thrombosis - pathology
Ticagrelor
Ticlopidine - analogs & derivatives
Ticlopidine - therapeutic use
Ultrasonic imaging
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Summary:Early stent thrombosis (EST) (≤ 30 days after stent implantation) is a relatively rare but deleterious complication of percutaneous coronary intervention (PCI). Administration of newer P2Y12 inhibitors (prasugrel and ticagrelor) combined with aspirin has been shown to reduce the incidence of sub-acute and late stent thrombosis, compared with clopidogrel. We investigated the "real life" incidence of EST in patients from a large acute coronary syndrome (ACS) national registry, where newer P2Y12 inhibitors are widely used. Patients were derived from the ACS Israeli Survey (ACSIS), conducted during 2006, 2008, 2010 and 2013. Major adverse cardiac events (MACE) at 30days were defined as all-cause death, recurrent ACS, EST and stroke.Of the 4717 ACS patients who underwent PCI and stenting, 83% received clopidogrel and 17% newer P2Y12 inhibitors. The rate of EST was similar in both groups (1.7% in the newer P2Y12 inhibitor group vs. 1.4% in the clopidogrel-treated patients, p = 0.42). Results were consistent after multivariate analysis (adjusted HR = 1.06 [p = 0.89]). MACE occurred in 6.4% in the newer P2Y12 inhibitor group compared with 9.2% in the clopidogrel group (P
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0157437