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Clinical presentation & outcomes of stent thrombosis Spanish registry ESTROFA (n=23,500)

Clinical presentation & outcomes of stent thrombosis Spanish registry ESTROFA (n=23,500). Overall (n=301). Acute/Subacute (n=149). Late (n=152). p. Presentation. STEMI. 83.7%. 86%. 81.5%. 0.36. Shock. 20.5%. 21%. 20.4%. 0.98. TIMI 0/1. 88%. 92%. 84.2%. 0.056. Outcomes.

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Clinical presentation & outcomes of stent thrombosis Spanish registry ESTROFA (n=23,500)

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  1. Clinical presentation & outcomes of stent thrombosisSpanish registry ESTROFA (n=23,500) Overall (n=301) Acute/Subacute (n=149) Late (n=152) p Presentation STEMI 83.7% 86% 81.5% 0.36 Shock 20.5% 21% 20.4% 0.98 TIMI 0/1 88% 92% 84.2% 0.056 Outcomes In-hospital Death 11.6% 13% 9.8% Thrombosis 1.66% 2.7% 0.66% Follow-up n=216 n=128 n=133 Time, mo 11.810 1511 8.87.6 Death 16% 18.8% 13.1% Thrombosis 4.6% 6% 3.3% J Am Coll Cardiol 2008;51:986–90

  2. DECREASE Study Design The patients undergoing successful DES implantation Operator decisions for adding cilostazol Triple group (n=1443) Dual group (n=1656) Inverse-Probability-of-Treatment-Weighted (IPTW) for the Entire cohort Propensity score matching (965 pairs) Dual antiplatelet group (n=965) Triple antiplatelet group (n=965) Clinical follow-up at 12 months (Death, MI, or stent thrombosis)

  3. 12-month clinical outcomes Study endpoint Primary endpoint Death Myocardial infarction Stent thrombosis (definite and probable by ARC) Secondary endpoint • Death or Myocardial infarction • TIMI Major bleeding • TIMI minor bleeding

  4. Twelve-month risk of Events after DES Implantation of Triple versus Dual antiplatelet therapy according to analytic methods Variables Crude Inverse-probability-of-treatment weighted Propensity-matched (965 pairs) Hazard Ratio (95% CI) P Value Hazard Ratio (95% CI) P Value Hazard Ratio (95% CI) P Value Cardiac events Death 0.925 (0.521 -1.644) 0.7907 0.762 (0.401-1.448) 0.4062 0.644(0.300-1.381) 0.2584 MI 0.381 (0.138-1.048) 0.0617 0.233 (0.077-0.703) 0.0097 0.298 (0.082-1.086) 0.0665 Stent thrombosis 0.286 (0.081-1.013) 0.0524 0.136 (0.035-0.521) 0.0036 0.124 (0.016-0.996) 0.0496 Death/MI 0.761 (0.464-1.251) 0.2817 0.591 (0.3364-1.037) 0.0665 0.556 (0.287-1.075) 0.0811 Bleeding Major bleeding 0.850 (0.477-1.516) 0.5830 0.969 (0.443-2.119) 0.9372 0.683 (0.343-1.360) 0.2781 Minor bleeding 1.039 (0.757-1.426) 0.8125 1.062 (0.734-1.537) 0.7504 1.045 (0.703-1.555) 0.8267 Hazard ratios are for the triple group, as compared with the dual group.

  5. Adjusted Landmark Analysis using IPTW in patients without events at landmark months Triple therapy beyond 1 month, Triple therapy (n=974) vs. Dual therapy (n=1646) Outcome HR 95%CI p-value Death 1.192 0.591 2.403 0.6238 Myocardial infarction 0.346 0.088 1.365 0.1295 Stent thrombosis 0.108 0.013 0.918 0.0415 Death/ Myocardial infarction 0.931 0.493 1.758 0.8262 Triple therapy beyond 3 month, Triple therapy (n=394) vs. Dual therapy (n=1638) Outcome HR 95%CI p-value Death 0.832 0.183 3.776 0.8116 MI 0.553 0.066 4.615 0.5841 Stent thrombosis NA NA NA NA Death/ Myocardial infarction 0.754 0.210 2.704 0.6645 Triple therapy beyond 6 month, Triple therapy (n=253) vs. Dual therapy (n=1631) Outcome HR 95%CI p-value Death 0.709 0.090 5.570 0.7441 MI NA Stent thrombosis NA Death/ Myocardial infarction 0.474 0.062 3.611 0.4711

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