Baran et al reported a clinical risk score associated with stent thrombosis. This can help to identify a patient who may benefit from more aggressive management. The authors are from multiple institutions in the United States participating in the ARRIVE registry of Boston Scientific Corporation.
Patient selection: stent in coronary artery
Parameters:
(1) discontinuation of thienopyridine therapy
(2) diabetes requiring insulin
(3) stenting of left main coronary artery
(4) smoking
(5) length of lesion in mm
(6) number of stents
(7) severity of calcification at lesion being stented
(8) diameter of reference vessel in mm
|
Parameter |
Finding |
Points |
|
discontinuation of thienopyridine therapy |
< 6 months |
5 |
|
|
not discontinued or discontinued >= 6 months |
0 |
|
diabetes requiring insulin |
no |
0 |
|
|
yes |
5 |
|
stenting of left main |
no |
0 |
|
|
yes |
3 |
|
smoking |
no |
0 |
|
|
yes |
3 |
|
length of lesion |
<= 28 mm |
0 |
|
|
> 28 mm |
2 |
|
number of stents |
1 |
0 |
|
|
2 or more (multiple) |
2 |
|
severity of calcification |
mild |
0 |
|
|
moderate to severe |
2 |
|
reference vessel diameter |
< 3 mm |
2 |
|
|
>= 3 mm |
0 |
total score =
= SUM(points for all 8 parameters)
Interpretation:
• minimum score: 0
• maximum score: 24
• The higher the score the greater the risk of stent thrombosis.
|
Total Score |
Risk of Stent Thrombosis |
Percent with Stent Thrombosis |
|
<= 6 |
low |
0.8% |
|
7 to 13 |
moderate |
3.6% |
|
>= 14 |
high |
12.6% |
Specialty: Cardiology
ICD-10: ,
