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Vol. 62. Issue 7.
Pages 834 (July 2009)
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Vol. 62. Issue 7.
Pages 834 (July 2009)
DOI: 10.1016/S1885-5857(09)72373-4
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Manuel Martínez-Sellésa, Laura Gallegoa, Fernando Sarnago Cebadaa, Francisco Fernández Avilésa
a Servicio de Cardiología, Hospital General Universitario Gregorio Marañón, Madrid, Spain
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To the Editor:

We would like to thank the interest taken by Flores-Rios et al. As we mentioned in our article,1 our data does not allow us to calculate the risk of stent thrombosis (ST). The estimation of the incidence of confirmed ST in our study, 6/1000 implanted stents, is similar to the accumulated incidence of 0.6% in 3 years in a meta-analysis of 3445 patients2 or that of 0.6% in 15 months of a consecutive series of 12 395 patients.3 Some studies, especially those that include probable and possible thrombosis, show greater incidences. However, the risk of including patients without a true ST is evident.4 Recently it has been proved that this happens even in studies with angiographic confirmation.5

Concerning intrahospital mortality (5.2%), it is similar to that of published studies that, such as ours, include both conventional and drug-eluting stents that vary between 0% to 6%.6-8

With 14 acute ST, 27 sub-acute ST, and only 9 late ST and 8 very late ST, the possibility to correlate the complications of the initial intervention and the chronological type of the thrombosis is limited. In any case, the distribution of ST in the 25 patients with these complications was 10 acute, 11 subacute, and 4 late, which could indicate earlier ST in this subgroup. We did not find ST in any drug-eluting stent implanted inside of a conventional one.

Gallego L, Martínez-Sellés M, García E, Franco J, Estévez A, Sarnago Cebada F, et al..
Caracterización y pronóstico de la trombosis del stent comprobada angiográficamente..
Rev Esp Cardiol, 62 (2009), pp. 220-3
Ellis SG, Colombo A, Grube E, Popma J, Koglin J, Dawkins KD, et al..
Incidence, timing, and correlates of stent thrombosis with the polymeric paclitaxel drug-eluting stent: a TAXUS II, IV, V, and VI meta-analysis of 3445 patients followed for up to 3 years..
J Am Coll Cardiol, 49 (2007), pp. 1043-51
Jensen LO, Maeng M, Kaltoft A, Thayssen P, Hansen HH, Bottcher M, et al..
Stent thrombosis, myocardial infarction, and death after drug-eluting and bare-metal stent coronary interventions..
J Am Coll Cardiol, 50 (2007), pp. 463-70
Martínez-Sellés M..
Defining stent thrombosis: whose definition to use? J Am Coll Cardiol..
, 41 (2003), pp. 1420
Agostoni P, Vermeersch P, Knaapen M, Verheye S..
Stent thrombosis is not always stent thrombosis: De novo atherosclerosis in a stented coronary segment..
Int J Cardiol, (2009 Jan 20 [Epub ahead of print]),
van Werkum JW, Heestermans AA, de Korte FI, Kelder JC, Suttorp MJ, Rensing BJ, et al..
Long-term clinical outcome after a first angiographically confirmed coronary stent thrombosis: an analysis of 431 cases..
Circulation, 119 (2009), pp. 828-34
Aoki J, Lansky AJ, Mehran R, Moses J, Bertrand ME, McLaurin BT, et al..
Early stent thrombosis in patients with acute coronary syndromes treated with drug-eluting and bare metal stents: the Acute Catheterization and Urgent Intervention Triage Strategy trial..
Circulation, 119 (2009), pp. 687-98
Park DW, Park SW, Lee SW, Kim YH, Lee CW, Hong MK, et al..
Frequency of coronary arterial late angiographic stent thrombosis (LAST) in the first six months: outcomes with drug-eluting stents versus bare metal stents..
Am J Cardiol, 99 (2007), pp. 774-8
Revista Española de Cardiología (English Edition)

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