Acute Stent Thrombosis in Patients Undergoing Primary Percutaneous Coronary Intervention: Insights from a Tertiary Care Cardiac Center

Abstract

Objectives: To determine the frequency of acute stent thrombosis (ST) in patients undergoing primary percutaneous coronary intervention (PPCI) at CPEIC Multan. Methodology: This longitudinal descriptive study was conducted at Chaudhary Pervez Elahi Institute of Cardiology (CPEIC), Multan, over a six-month period. A total of 468 consecutive patients presenting with ST-elevation myocardial infarction (STEMI) and scheduled for PPCI were enrolled. All patients were monitored for 24 hours post-procedure. Acute stent thrombosis was diagnosed in patients who developed new-onset chest pain and was confirmed via repeat coronary angiography. Results: The mean age of participants was 50.3 ± 8.1 years, with 59% (n = 276) aged ≥50 years and 84.8% (n = 397) being male. The prevalence of comorbidities was: diabetes mellitus 32.3% (n = 151), hypertension 44.7% (n = 209), smoking 45.5% (n = 213), dyslipidemia 28.0% (n = 131), and family history of coronary heart disease 15.8% (n = 74). Acute stent thrombosis occurred in 4.3% (n = 20) of patients. Stratified analysis revealed significantly higher ST rates in females versus males (9.9% vs. 3.3%), diabetics versus non-diabetics (12.6% vs. 0.3%), hypertensive versus non-hypertensive patients (8.6% vs. 0.8%), and those with dyslipidemia versus those without (7.6% vs. 3.0%). Conclusion: The overall rate of acute stent thrombosis within 24 hours of PPCI was 4.3%. Female sex, diabetes, hypertension, and dyslipidemia were identified as significant risk factors.