Long-term health outcome and mortality evaluation after invasive coronary treatment using drug-eluting stents: HOME DES registry.

Aim: To assess the occurrence of late clinical events after the discontinuation of dual antiplatelet treatment in patients with drug-eluting stent implantation, complex coronary artery disease and high clinical risk profile.

Methods: Between January 2004 and December 2005, 2080 patients underwent percutaneous coronary intervention, including 276 patients (13%) who were treated with drug-eluting stents. At the 6-month follow-up, 273 patients remained event-free and of these, 171 completed the 12-month and 18-month follow-ups and have been enrolled in the analysis. Dual antiplatelet treatment was administered for 6 months in all patients.

Results: At the 18-month follow-up, stent thrombosis had occurred in 10 patients (5.8%), resulting in five sudden deaths and five target-vessel nonfatal myocardial infarctions. The majority (80%) of the events had developed within 7-12 months. The larger stent area and left main interventions were significantly associated with stent thrombosis (P=0.031 and P=0.001, respectively).

Conclusions: Our study confirmed worrisome results concerning drug-eluting stent thrombosis after the discontinuation of dual antiplatelet treatment. The rate of stent thrombosis-related events in our high-risk cohort of patients reached almost 6% with a 50% mortality. The majority (80%) of the events occurred within the months 7-12.