One year incidence of events after definite coronary stent thrombosis: a retrospective vs prospective comparison and a conglomerate determination of prognostic factors of mortality

Abstract Background Although many studies analysed the predictive factors of coronary stent thrombosis (ST), there are few data on prognostic factors of clinical outcomes after definite ST. The purpose of the current study was to analyse clinical presentation and outcomes at one year after definite coronary ST in two distinct cohorts: a retrospective cohort and a prospective cohort and to determine the prognostic factors. Methods Among 22’039 consecutive patients treated between January 2008 and December 2021, 275 patients presented a definite ST and were included in this study (retrospective cohort n=83 and prospective cohort n=192). Baseline characteristics, clinical ST presentation and 1-year outcomes were analysed between the two cohorts using SPSS Software. According to the obtained results data of both cohorts were pooled and prognostic factors of clinical outcomes determined using multivariate analysis. Results There was no statistical difference between the two cohorts concerning baseline characteristics and clinical ST presentation. All-cause mortality and MACE rate up to 1 year follow-up did not differ either among cohorts (16.9% vs 14.6%, p=0.764 for mortality (Figure 1) and 26.5% vs 24% p=0.766 for MACE). Multivariate analysis of the aggregated data of both prospective and retrospective cohorts revealed age (OR: 1.05 95% CI [1.02;1.09]; p=0.0016), early stent thrombosis (OR: 3.3 95% CI [1.52;7.15] p=0.002), severe renal failure (OR: 3.37 95% CI [1.35;8.42] p=0.009), clinical presentation (cardiogenic shock [OR: 2.92 95% CI {1.17;7.28} p=0.02] and cardiac arrest [OR: 15.3 95% CI {6.62;35.39} p<0.0001]) as strongly associated with a higher risk of death at 1 year whereas higher LVEF was a protective factor (OR: 0.922 95% CI [0.891; 0.955] p<0.0001). Conclusion Comparing retrospectively collected data versus prospectively collected data for definite ST showed very similar data concerning qualitative variables (e.g. baseline characteristics and clinical presentation of ST) suggesting feasibility of data pooling to determine prognostic factors of clinical outcome at one year. Prognostic factors influencing one-year all-cause mortality were age, early ST thrombosis, renal failure, residual LVEF and clinical presentation.Figure 1