Incidencia de trombosis de stents coronarios en el «mundo real»

BACKGROUND: The existing evidence of drug-eluting stents comes from controlled studies done with strict inclusion criteria, limiting their conclusions and making difficult to apply their findings in the real world. OBJECTIVES: determine the incidence of thrombosis between bare metal stents versus drug-eluting stents in patients in the «real world» METHODS: incidence study to determine the number of cases of thrombosis in implanted stents through information gathered from clinical records, data bases and clinical follow-up, based on demographic characteristics, risk factors, clopidogrel treatment and events of stent thrombosis with a 0 days to 1 year follow-up. RESULTS: 640 stents were implanted. 69.2% were bare metal stents and 30.8% drug-eluting stents, from which 18.9% were with placlitaxel and 11.9% with sirolimus. 12 thrombosis events were identified (7 with drug-eluting stents and 5 with bare metal stents). The incidence of thrombosis with any kind of stent was 1.88 %( CI 95% 0.97-3.28). The incidence of thrombosis with drug-eluting stents was 3.55% (CI 95%1.43-7.32), and with bare metal stents 1.13% (CI 95% 0.37-2.64) p=0.000. The relative risk of thrombosis with drug eluting stents is 3.14 (CI 95%1.01-9.78) p=0.037. The relative risk of thrombosis with drug eluting stents and acute myocardial infarction is 8.11 (CI 95%2.32-28.31) p=0,001. CONCLUSIONS: there is an increased incidence of thrombosis of coronary stents in the real world and a greater risk of thrombosis with drug eluting stents, especially when implanted in the context of an acute myocardial infarction. It is necessary to conduct further studies that may involve a higher sample of patients population and long-term follow-up.