Abstract

*Dr. Sana Naseer, Dr. Amna Abdul Karim and Dr. Faisal Anwar

ABSTRACT

Objectives: To compare the frequency of stent thrombosis (acute and subacute) between bare metal stents and drug eluting stents in 1 month follow up. Duration: Six months from 12th January 2017 to 11th July 2017. Sample size: 300 consecutive patients of coronary artery disease undergoing PCI with bare metal or drug eluting stents (150 patients of each type of stent). Methods: After fulfilling the inclusion criteria 300 patients of coronary artery disease were studied. The total number of males in the study population was 254 (85%) with mean age 51± 9.814 years while female patients were 46 (15%) with mean age 55.83± 9.518 years. Smoking was the commonest risk factor in males while hypertension was commonest in females. 52% patients were admitted with initial diagnosis of unstable angina and 44% patients as acute myocardial infarction. 80% patient showed single vessel coronary artery disease on angiography. Half of the study population was deployed bare metal stents while half was deployed drug eluting stents. Acute stent thrombosis was not documented in our study. All the patients were advised to take regularly dual antiplatelet therapy following PCI. Results: Out of 300 patients, 3 patients developed subacute stent thrombosis which had initial diagnosis of unstable angina with single vessel coronary artery disease and PCI to LAD was done in all the three patients. 2 patients were deployed bare metal stents while one patient was deployed drug eluting stent. All the 3 patients were deployed stents having length of more than 20 mm. 2 patients who were deployed bare metal stents took regular antiplatelet therapy but they were readmitted within 8 days following PCI; one patient presented with acute myocardial infarction and second patient as a case of unstable angina. 3rd patient who was deployed drug eluting stent took irregular dual antiplatelet therapy due to intolerable gastrointestinal problem and he was readmitted on 29th day following PCI as a case of acute myocardial infarction. Out of 3 patients, 2 were hypertensive. In our study population not a single death was documented. The frequency of acute and subacute stent thrombosis in our study was 1% in one month follow up. Conclusion: Stent thrombosis is more common in patients of unstable angina with long lesions following PCI with bare metal stents. Patients with poor compliance to dual antiplatelet therapy following PCI have more risk of stent thrombosis. Commonest presentation of stent thrombosis is acute myocardial infarction.