Predictors of intra-procedural stent thrombosis (IPST) during percutaneous coronary intervention (PCI): a pooled data analysis

Abstract

Background: Among all PCI related intraprocedural thrombotic events, IPST is rare but associated with worst outcomes. Purpose: We conducted this study to identify specific patient and procedural characteristics that are associated with higher incidence of IPST. Methods: Data on patient and procedural characteristics from all the studies comparing IPST without IPST was pooled for the purpose of analysis. Results: 5 studies with a total of 21251 patients were included. IPST occurred in 170 patients (0.8%). History of a prior PCI (assumed to be on dual or single anti-platelet agent)was associated with decrease in IPST. IPST occurred more in smokers, patients with abnormal cardiac enzymes at presentation, presentation with STEMI. Incidence of IPST was significantly higher in interventions involving left main artery or bifurcation or with bare metal stent placement. A low pre-TIMI flow of 0 or 1, baseline thrombus, not using upstream GpIIb inhibitors also significantly increased incidence of IPST. Conclusion: Further studies are needed to validate above described patient and procedural risk factors. Using upstream GpIIb inhibitors in this specific high-risk population may help in prevention.