Background: Early stent thrombosis (EST) (i.e. ≤ 30 days after stent implantation) is a relatively rare but deleterious complication of percutaneous coronary intervention (PCI). Administration of the newer P2Y12 inhibitors (i.e. prasugrel and ticagrelor) in conjugation with aspirin has demonstrated a decrement in the incidence of sub-acute and late stent thrombosis in comparison to clopidogrel.
Aim: To investigate the “real life” incidence of EST in large national registry in a setting where newer P2Y12 inhibitors are widely used.
Methods: Patients were derived from the acute coronary syndromes Israeli survey (ACSIS), conducted during 2006, 2008, 2010, 2013. Major adverse cardiac events (MACE) at 30-days were defined as all cause death, recurrent ACS, EST and stroke.
Results: Of the 4717 patients with ACS who underwent PCI and stenting, 83% were treated with clopidogrel; 11% with prasugrel and 7% with ticagrelor. MACE rate was 10.4% in the clopidogrel group compared with 7% and 8% in the prasugrel and ticagrelor group, respectively (p=0.03). Nevertheless, EST rate was similar in all groups (1.4% for clopidogrel; 1.6% for prasugrel and 2% of ticagrelor group, p=0.6). Moreover, EST rate (1%, 2.5%, 1.1%, 1.5%) did not differ significantly between the years 2006, 2008, 2010, 2013, respectively.
Conclusion: The incidence of EST following PCI in ACS was similar between patients who had received newer anti-platelets agents and clopidogrel. Nevertheless, MACE rate was lower in patients who had received newer anti-platelets agents.
