Clinical Outcomes and Management Strategies for Stent Thrombosis in Primary Percutaneous Coronary Intervention: A Comparative Analysis of Acute and Subacute Cases

Abstract

Objectives: This study evaluates the clinical outcomes and management strategies for stent thrombosis (ST) in patients undergoing primary percutaneous coronary intervention (PCI), with a focus on comparing acute and subacute ST outcomes. Methodology: A retrospective analysis of 129 patients with angiographically confirmed ST was conducted. Data on demographics, clinical outcomes, Thrombolysis in Myocardial Infarction (TIMI) flow grades, bleeding complications, and mortality rates were extracted from hospital records. TIMI flow assessments were blinded, and procedural details were standardized to minimize bias. Statistical analyses included descriptive and inferential tests, with significance set at P < 0.05. Results: Among the 129 patients, 29 (22.48%) experienced myocardial infarction, and 46 (35.66%) required revascularization (P = 0.004). TIMI flow grade 3 was achieved in 97 patients (75.2%), whereas 12 patients (9.3%) had TIMI grade 0 (P = 0.003). Bleeding events occurred in 15 patients (11.6%), including three major cases classified as BARC 3 (P = 0.02). The in-hospital mortality rate was 7% (n=9), significantly associated with delayed PCI and advanced age (P = 0.05). The overall survival rate was 93%, underscoring the effectiveness of timely PCI in managing ST. Conclusion: Primary PCI remains an effective intervention for managing ST, demonstrating high success in restoring coronary perfusion and mitigating complications. However, early intervention and tailored management strategies are crucial in minimizing adverse outcomes. Future research should explore advanced risk stratification tools and optimized treatment protocols to enhance patient outcomes.