Predictors for Stent Thrombosis in Treated Bifurcation Lesions

Background and Objectives:
Data on predicting stent thrombosis (ST) in bifurcation lesions is limited, thus, we aimed at defining predictors for ST in patients with bifurcation lesions.

Methods:
We analyzed 1,037 consecutive patients, who underwent PCI for bifurcation lesions in our medical center. Definite ST was evaluated after 6, 12, and 24 months.

Results:
Patients` characteristics and ST outcomes are depicted in the Table:

Mortality associated with ST:

Univariate analysis predictors for ST were: age, left ventricular ejection fraction (LVEF) ≤40% , 2-stent strategy and final KBI was a negative predictor for ST. Multivariate analysis revealed that LVEF ≤40% predicted ST after 6 months [OR; 7.2, 95% CI 2.3-22.3, p=0.0006], 12 months [OR; 5.0, 95% CI 1.8-14, p=0.002] and 24 months [OR; 5.8, 95% CI 2-17, p=0.001]. Final KBI decreases the rates of ST after 6 months [OR; 0.3, 95% CI 0.09-0.96, p=0.04] and 12 months [OR; 0.3, 95% CI 0.1-0.9, p=0.03], but not at 24 months. Two-stent strategy did not predict ST at all time intervals.

Conclusion:
ST after PCI in bifurcation lesions is associated with high mortality.

Low LVEF strongly predicts ST after PCI in bifurcation lesions during follow up. Final KBI profoundly decreases ST following bifurcation PCI. PCI in AMI patients does not predict ST in bifurcation lesions, neither does 2-stent strategy.