A122.E1143

JACC March 9, 2010

Volume 55, issue 10A

MYOCARDIAL ISCHEMIA AND INFARCTION

THE OUTCOME OF PRIMARY PERCUTANEOUS CORONARY INTERVENTION FOR STENT THROMBOSIS

CAUSING ST ELEVATION MYOCARDIAL INFARCTION

ACC Poster ContributionsGeorgia World Congress Center, Hall B5

Monday, March 15, 2010, 3:30 p.m.-4:30 p.m.

Session Title: Myocardial Ischemia/Infarction: Implications of StentsAbstract Category: Myocardial Ischemia/Infarction--Basic

Presentation Number: 1215-310

Authors: Mehmet Ergelen, Sevket Gorgulu, Huseyin Uyarel, Tugrul Norgaz, Huseyin Aksu, Erkan Ayhan, Zeki Y. Gunaydın, Turgay Isık, Gokhan Cicek,

Tuna Tezel, Department of Cardiology, Siyami Ersek Cardiovascular and Thoracic Surgery Center, Istanbul, Turkey, Department of Cardiology, Balıkesir

University, School of Medicine, Balıkesir, Turkey

Background: There are very few scientific data about the effectiveness of primary percutaneous coronary intervention (PCI) in patients with ST-

elevation myocardial infarction (STEMI) due to stent thrombosis (ST). The purpose of the present study is to investigate the efficiacy and outcome of

primary PCI for STEMI due to ST in the largest consecutive patient population with ST reported to date.

Methods: 2644 consecutive STEMI patients undergoing primary PCI were retrospectively enrolled into the present study. Primary PCI for definite

ST was considered a PCI due to angiographically confirmed thrombus that originated in the stent or in the segment 5 mm proximal or distal to the

stent. The patients with primary PCI were divided in a ST and a no-ST group.

Results: ST was the cause of STEMI in 118 patients (4.4 %). In patients with ST, angiographic success (postprocedural TIMI grade III flow) was

worse than in patiens with de novo STEMI (76.3% vs 84.8%;p=0.01). Patients with ST had significantly higher incidence of in-hospital cardiovascular

mortality than patients with de novo STEMI (10.2% vs 5,3%, p=0.02). In-hospital reinfarction rate was similar in both groups. In addition, long-term

cardiovascular mortality and reinfarction rates were significantly higher in patients with ST compared with those without. (17.4% vs 10.5%, p=0.02;

15.6% vs 9.5% , p=0.03 respectively).

Conclusions: Primary PCI for treatment of ST is less effective, and these patients are at increased risk for inhospital and long term mortality

compared to patients undergoing primary PCI due to de novo STEMI.