Comparison of Clinical Characteristics of Stent Thrombosis Between the Right Coronary Artery and the Left Coronary Artery　― A Subanalysis of the REAL-ST Registry ―

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Background:Stent thrombosis (ST) remains a severe complication following stent implantation. We previously reported the risk factors for ST after 2nd-generation drug-eluting stent (DES) in the REAL-ST (Retrospective Multicenter Registry of ST After First- and Second-Generation DES Implantation) registry.

Methods and Results:In this subanalysis, we aimed to reveal the difference in ST between right coronary (RCA) and left (LCA) coronary arteries. A total of 307 patients with ST were divided into the RCA-ST group (n=93) and the LCA-ST group (n=214). Multivariate analysis revealed younger age (odds ratio [OR] 0.96, 95% confidence interval [CI] 0.93–0.99, P=0.01), ostial lesion at the time of index percutaneous coronary intervention (OR 4.37, 95% CI 1.43–13.33, P=0.01), bifurcation lesion at the time of index PCI (OR 0.05, 95% CI 0.02–0.12, P<0.01), chronic total occlusion (CTO) lesion at the time of index PCI indication (OR 4.19, 95% CI 1.05–16.71, P=0.04), and use of prasugrel at the time of ST (OR 7.30, 95% CI 1.44–36.97, P=0.02) were significantly associated with RCA-ST.

Conclusions:Younger age, ostial or CTO lesion, and use of prasugrel at the time of ST were prominent factors in RCA-ST, whereas bifurcation lesion was associated with LCA-ST. We should pay attention to the differences between RCA-ST and LCA-ST to prevent ST.