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Inicio Revista Colombiana de Cardiología Incidencia de trombosis de stents coronarios en el «mundo real»
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Vol. 17. Núm. 3.
Páginas 99-105 (Mayo - Junio 2010)
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Vol. 17. Núm. 3.
Páginas 99-105 (Mayo - Junio 2010)
Open Access
Incidencia de trombosis de stents coronarios en el «mundo real»
Incidence of coronary stent thrombosis in the «real world»
Visitas
1831
Bernardo Lombo1,
Autor para correspondencia
berlombo@yahoo.com

Correspondencia: Calle 116 No. 9-02 Piso 2. Bogotá, DC., Colombia. Teléfono (571) 6030303 ext.: 5061 - 5069.
, Iván Rendón1, Claudia Satizábal2, Carolina Rivas3, Daniel Sarmiento1, Carlos Carvajal1, Jorge Mor1, José G. Diez4
1 Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, D.C, Colombia
2 Universidad de los Andes, Bogotá, D.C, Colombia
3 Epidemiología, Universidad El Bosque, Bogotá, D.C, Colombia
4 Baylor College of Medicine, Houston, Texas
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Información del artículo
Antecedentes

la evidencia disponible de stents liberadores de medicamento proviene de estudios controlados con estrictos criterios de inclusión, limitando sus conclusiones y haciendo difícil la aplicación de sus resultados en el mundo real.

Objetivo

determinar la incidencia de trombosis de stents liberadores y no liberadores de medicamento en pacientes del «mundo real».

Metodología

estudio de incidencia para determinar el número de casos de trombosis de stents implantados, mediante información obtenida a partir de historias clínicas, bases de datos y seguimiento clínico, y con base en características demográficas, factores de riesgo, consumo de clopidogrel y casos de trombosis del stent con un seguimiento de cero días a un año.

Resultados

640 stents implantados (69,2% no medicados, 30,8% medicados de los cuales 18,9% eran medicados con placlitaxel y 11,9% medicados con sirolimus). Se identificaron doce eventos de trombosis (siete stents medicados y cinco no medicados). La incidencia de trombosis con cualquier tipo de stent fue de 1,88% (IC 95% 0,97–3,28). La incidencia de trombosis con stent medicado fue 3,55% (IC 95% 1,43–7,32), y con stent no medicado 1,13% (IC 95% 0,37–2,64) p=0,000.

El riesgo relativo de trombosis con stent medicado es de 3,14 (IC 95% 1,01–9,78) p=0,037.

El riesgo relativo de presentar trombosis con stent medicado en infarto agudo del miocardio es 8,11 (IC 95% 2,32–28,31) p=0,001.

Conclusiones

la incidencia de trombosis del stent aumenta en el mundo real, y existe mayor riesgo de trombosis de stents medicados especialmente cuando son implantados en el contexto de un infarto agudo del miocardio.

Es necesario realizar estudios futuros que involucren una población de pacientes más amplia y con seguimiento a largo plazo.

Palabras clave:
trombosis
stents
cardiología intervencionista
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 drugeluting 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.

Key words:
thrombosis
stents
interventional cardiology
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Copyright © 2010. Socidad Colombiana de Cardiología y Cirugía Cardiovascular
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