No Significant Difference in Late Thrombosis with SES, PES
Diabetes and acute coronary syndromes were the only predictors of stent thrombosis.
According to data from the Bern-Rotterdam cohort study, early and late stent thrombosis occurs with both sirolimus-eluting and paclitaxel-eluting stents, without significant differences between the types.
Peter Wenaweser, MD, from the University Hospital of Bern in Switzerland, said Tuesday that angiographically proven thrombosis with drug-eluting stents occurred at a rate of 1.3 events per 100 patient years and a cumulative incidence of 2.8% at three years. Acute coronary syndromes and diabetes were the only independent predictors of overall stent thrombosis.
The Bern-Rotterdam study looked at the incidence and time course of stent thrombosis in routine clinical practice in a large cohort of consecutive patients with long-term follow-up.
The study also sought to assess the differences between the two drug-eluting stents, the differences between early and late stent thrombosis with these stents and the predictors of stent thrombosis.
Study findings
Of 8,146 consecutive patients receiving drug-eluting stents who were enrolled between April 2002 and December 2005, 152 developed stent thrombosis (Figure 1).
Dual antiplatelet therapy was far more common in patients experiencing early vs. late thrombosis (Figure 2).
The rates of stent thrombosis at 3 years between sirolimus- and paclitaxel-eluting stents were statistically equivalent (2.5% with sirolimus-eluting stents vs. 3.2% with paclitaxel-eluting stents).
Wenaweser noted several limitations of the study. First, the study was a nonrandomized cohort study that involved two tertiary care centers. Second, the stent type and antiplatelet therapy were determined by local institutional practice.
Also, Wenaweser said, the analysis was limited to angiographic stent thrombosis, and intravascular ultrasound was not routinely performed in these patients.
Finally, no comparison was made between patients treated with drug-eluting stents and those treated with bare-metal stents.