BACKGROUND: There are limited data regarding the temporal trends and outcomes of stent thrombosis (ST) in the contemporary era of potent P2Y12 inhibitors, newer generation drug eluting stents, and intracoronary imaging.
OBJECTIVES: To examine the trends, characteristics, and outcomes of patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI) for ST in the United States.
METHODS: Patients undergoing PCI for AMI between April 2018 and June 2023 were identified from the NCDR CathPCI Registry. The rates of PCI for ST were evaluated over time using linear regression. In-hospital outcomes of PCI for ST versus no ST were compared using hierarchal multivariable logistic regression.
RESULTS: Among 2,023,032 patients undergoing PCI for AMI, 57,268 (2.8%) were for ST. The timing of ST was early (18,189/55,351;31.8%), late (8,825/55,351; 15.4%), very late (28,337/55,351; 49.5%), or unknown (1,917/55,351; 3.4%). There was no temporal change in the frequency of PCI for ST during the study period. PCI for ST was associated with a higher incidence of major adverse cardiac events (adjusted odds ratio [aOR] 1.24; 95% confidence intervals [CI] 1.19-1.29), all-cause mortality (aOR 1.17; 95% CI 1.12-1.22), recurrent MI (aOR 1.80; 95% CI 1.63-1.98), and major bleeding (aOR 1.18; 95% CI 1.15-1.22), compared with PCI for non-ST.
CONCLUSIONS: In this contemporary, nationwide, real-world analysis, there was no temporal change in the frequency of PCI for ST. Most ST were early or very late. PCI for ST was associated with higher in-hospital adverse outcomes.
Editors
Editor-in-Chief
Harlan M. Krumholz, MD, SM, FACC
CME Editor
Ragavendra R. Baliga, MD
Author
Islam Y. Elgendy, MD, FACC
Important Dates
Date of Release: March 9, 2026
Term of Approval/Date of CME/MOC Expiration: March 8, 2027