Incidence of stent thrombosis in BMS

Multiple contemporary studies involving single center and multi center experience suggests an overall incidence of 0.5 % - 2.5 %. (1,2,3,4,5) There is some variation of these numbers with the definitions used. For instance, in a recent study of 8847 patients who received a BMS, a cumulative incidence of definite, probable or possible ST over 15 months was 2.15% and that for definite ST was 0.61% (6) In a study involving serial angioscopy after sirolimus-eluting stent (SES) implantation at 4, 11, and 21.2 ±2.2 months no BMS had thrombus in 11 patients. (11)

Incidence of early ST in BMS
In the current environment the overall incidence of acute ST with BMS is ≈ 0.5%.
 * For purposes of discussion this group would include
 * intra-procedural ST
 * acute ST up to 24 hrs
 * subacute – 24 hrs to 30 days

In study of 7484 patients with (intra vascular ultrasound study) IVUS before and after stenting, incidence of ST was 0.4% up to a week. The median time of ST was 24 hours and the minimum time was 1 hour. (7)

In the current environment the overall incidence of acute ST with BMS is ≈ 0.5%

In a retrospective analysis 4509 patients the rate of subacute ST was 0.51%. (8)

In a study of 7484 patients with IVUS interrogation of the stent, ST of 0.4% was reported up to one week with a median time of 24 hours. (7)

The incidence of subacute ST could be higher in special patient populations. In a group of 40 patients who underwent non cardiac surgery following BMS, the incidence of ST while on two antiplatelet agents appeared to be 2.5 % (one patient out of 40). (9)

For purposes of discussion this would include ST from 30 days till up to 3 years or longer
The reported incidence in this group ranges between 0-0.5%. Given the paucity of data only assumptions can be made for the group beyond 1-3 years.
 * This would include
 * Late ST            –> 30 days to one year
 * Very late ST       –> more than one year, but generally less than 3 years
 * Later than 3 years

The incidence of late ST with BMS was 0.28% in a meta-analysis of 14 trials looking at 6675 patients. (10)

It appears that ST in the very late group is exceedingly rare.

In a meta-analysis of 14 trials looking at 6675 patients no patient presentetd with very late ST of BMS. How ever regular follow up of most patients confined to one year or less. (10)