TY - JOUR JO - EuroIntervention TI - Timing and predictors of definite stent thrombosis in comatose survivors of out-of-hospital cardiac arrest undergoing percutaneous coronary intervention and therapeutic hypothermia (ST-OHCA study) AB - <p><strong>Background</strong>: Incidence of stent thrombosis (ST) in comatose survivors of out-of-hospital cardiac arrest (OHCA) undergoing immediate percutaneous coronary intervention (PCI) and therapeutic hypothermia (TH) varies considerably, from 2.7% to 31.2%, in retrospective studies.</p> <p><strong>Aims</strong>: We aimed to investigate occurrence, timing and predictors of definite ST.</p> <p><strong>Methods</strong>: We prospectively investigated consecutive comatose survivors of OHCA with presumed cardiac aetiology undergoing immediate PCI with drug-eluting stents (DES) and TH targeted at 32-34&deg;C admitted between August 2016 and July 2021. Repeat coronary angiography (CAG) was performed if ST was suspected and systematically between day 8-12 in the absence of clinical signs. All deceased patients underwent autopsy and histopathological analysis.&nbsp;</p> <p><strong>Results</strong>: Among 362 comatose survivors of OHCA, immediate PCI with stenting was performed in 169 patients (47%). Since 18 patients did not complete follow-up, 151 patients were ultimately enrolled in ST analysis. Definite ST was confirmed in 29 patients (19.2%; 95% confidence interval [CI]: 12.9%-25.6%) either by CAG (n=18) or autopsy (n=11). ST occurred within 3 days in 62% and presented with at least one clinical sign in 79%. Survival with good neurological recovery was observed in 17% of patients with ST and in 60% of patients without ST (p&lt;0.001). Independent predictors of ST were longer prehospital resuscitation, lower arterial pH and increased creatinine on admission.</p> <p><strong>Conclusions</strong>: The incidence of definite ST in comatose survivors of OHCA undergoing immediate PCI and TH targeted at 32-34&deg;C is substantial (19.2%) and significantly higher than in other PCI subsets despite systematic use of contemporary DES and anticoagulation/antiplatelet treatment.&nbsp;</p> AU - Rauber Martin AU - Nicol Philipp AU - Sabic Emina AU - Joner Michael AU - Noc Marko VL - IS - Y1 - 25/07/2022 Y1 - 2022 DOI - 10.4244/EIJ-D-22-00336 SP - KW - drug-eluting stent KW - out-of-hospital cardiac arrest KW - stent thrombosis PB - Europa Digital & Publishing UR - https://eurointervention.pcronline.com/article/timing-and-predictors-of-definite-stent-thrombosis-in-comatose-survivors-of-out-of-hospital-cardiac-arrest-undergoing-percutaneous-coronary-intervention-and-therapeutic-hypothermia-st-ohca-study SN - 1774-024X ER -