Late and very late stent thrombosis with drug eluting stents still continue to be our concern. Fresh data from the jCypher registry is available from Kimura T and associates [Very Late Stent Thrombosis and Late Target Lesion Revascularization after Sirolimus-Eluting Stent Implantation: Five-year Outcome of the j-Cypher Registry. CIRCULATIONAHA.111.046599. Published online before print December 27, 2011, doi: 10.1161/?CIRCULATIONAHA.111.046599]. In this group of over twelve thousand and eight hundred patients undergoing sirolimus eluting stent implanation, the one month stent thrombosis was 0.3% while the one year cumulative stent thrombosis rate was 0.6%. Five year cumulative stent thrombosis rate was 1.6%. Acute coronary syndrome and proximal left anterior descending coronary artery were risk factors for early stent thrombosis. Side branch stenting, diabetes mellitus and end stage renal disease with or without hemodialysis were risk factors for late stent thrombosis. Current smoking and total stent length more than twenty eight millimeters were risk factors for very late stent thrombosis. Early stent thrombosis was calculated at thirty days, late stent thrombosis at one year and very late stent thrombosis at five years. Late and very late stent thrombosis rates were calculated at 0.26% per year. Target vessel revascularization (TLR) within first year was low at 7.35%. Beyond one year, it continued at a rate of 2.2% per year upto five years.
Prof. Dr. Johnson Francis MD, DM, FACC, FRCP Edin, FRCP London
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28 Jul, 2011