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Internal and Emergency Medicine

, Volume 5, Issue 2, pp 121–126 | Cite as

Acute infection–inflammation and coronary stent thrombosis: an observational study

  • Stefano Del Pace
  • Maria Boddi
  • Raffaele RasoiniEmail author
  • Serena Micheli
  • Camilla Alderighi
  • Sabina Caciolli
  • Massimo Margheri
  • Rosanna Abbate
  • Gian Franco Gensini
IM - Original

Abstract

Coronary stent thrombosis (CST) is a major concern of interventional cardiology. Several risk factors for CST have been identified, but as a whole they do not explain the pathophysiology of CST. This study was designed to investigate whether acute infection–inflammation could facilitate the occurrence of CST. Forty-one patients, aged 66.6 ± 11 years, consecutively admitted to our catheterization laboratory for acute, subacute or late CST, were retrospectively analysed. Transient acute infection–inflammation on admission for CST was diagnosed by predefined criteria. Prevalence of known risk factors for CST was also investigated. Twenty-one patients (51%) met predefined criteria for the occurrence of acute infection–inflammation. On admission, in these patients, levels of systemic humoral and cellular inflammatory markers were significantly higher than those of patients without recent or ongoing acute infection–inflammation (p < 0.05 for all). 62% of patients with acute infection–inflammation had less than two known risk factors for CST whereas only 37% patients without infection–inflammation showed less than two risk factors (p = 0.03) and showed more frequent interruption of antiplatelet treatment (17 vs. 2.4%, p = 0.02), mean longer stent length (20.5 ± 4.8 vs. 16.5 ± 5.1 mm, p = 0.02) and lower left ventricular ejection fraction before CST (42.9 ± 14 vs. 47.3 ± 11%, p = 0.02). In conclusion, acute infection–inflammation could play a role in facilitating the occurrence of CST in a subgroup with low risk profile for known risk factors. Our findings, if confirmed, could suggest new opportunities for prevention and treatment of CST.

Keywords

Coronary artery disease Stent thrombosis Acute coronary syndromes Infection Inflammation 

Notes

Conflict of interest

None.

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Copyright information

© SIMI 2010

Authors and Affiliations

  • Stefano Del Pace
    • 1
  • Maria Boddi
    • 1
  • Raffaele Rasoini
    • 1
    Email author
  • Serena Micheli
    • 1
  • Camilla Alderighi
    • 1
  • Sabina Caciolli
    • 1
  • Massimo Margheri
    • 1
  • Rosanna Abbate
    • 1
  • Gian Franco Gensini
    • 1
  1. 1.Department of Heart and Vessels, Azienda Ospedaliera-Universitaria CareggiUniversity of FlorenceFlorenceItaly

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