Lots of interesting abstracts and cases were submitted for TCTAP 2022. Below are the accepted ones after a thorough review by our official reviewers. Don’t miss the opportunity to expand your knowledge and interact with authors as well as virtual participants by sharing your opinion in the comment section!
TCTAP A-009
Coronary Stent Thrombosis Prediction in Patients with Acute Coronary Syndrome
By Roman Risberg, Vladimir Plechev, Bogdan Oleynik, Vali Yunusov
Presenter
Roman Risberg
Authors
Roman Risberg1, Vladimir Plechev2, Bogdan Oleynik2, Vali Yunusov2
Affiliation
Republican Cardiology Center, Russian Federation1, Bashkir State Medical University, Russian Federation2
View Study Report
TCTAP A-009
Acute Coronary Syndromes (STEMI, NSTE-ACS)
Coronary Stent Thrombosis Prediction in Patients with Acute Coronary Syndrome
Roman Risberg1, Vladimir Plechev2, Bogdan Oleynik2, Vali Yunusov2
Republican Cardiology Center, Russian Federation1, Bashkir State Medical University, Russian Federation2
Background
On the basis of instrumental and laboratory methods, to determine the prognosis of the development of coronary stent thrombosis in acute coronary syndrome.
Methods
To achieve the aim of the study, we analyzed the treatment of 4028 patients who underwent urgent coronary stenting. In 4028 patients who underwent percutaneous stenting of coronary vessels, postoperative complications occurred in 285 (7%), including 59 cases (20.7%) - coronary stent thrombosis in the early postoperative period,in 226 cases (79.3 %) - restenosis in the coronary stent in the late postoperative period.
Results
A preliminary correlation analysis revealed the relationship between the risk of coronary stent thrombosis in acute coronary syndrome and echocardiographic data, as well as laboratory parameters (Tables 1, 2).
Based on the results of logistic regression of continuous signs, a prognostic model of the development of coronary stent thrombosis in the early postoperative period after emergency stenting of coronary vessels was constructed.
The probability (p) of coronary stent thrombosis in the early postoperative period based on this prognosis model is:
p = 1 / (1+ eFV * 0.024 + APTT * 0.071 + 0.603),
Where "e" is the base of the natural logarithm, a mathematical constant of approximately 2.718. The correctness of the forecast model is 98.7%.
The closer the value is to 1, the higher the risk of this postoperative complication. For convenience, the result can be multiplied by 100%. So, for example, with EF = 65% and APTT = 35 sec, the risk of coronary stent thrombosis in the early postoperative period after emergency stenting of coronary vessels is 0.95%, with a decrease in EF to 46% and APTT up to 29 sec, the risk increases to 2, 3%, and with a pronounced drop in EF to 40% and APTT up to 25 sec - up to3.3%.
Table 1 - Results of the correlation analysis of the risk of thrombosis in the coronary stent and echocardiography data (the values of the Gamma (G) coefficient are presented at p <0.05).
| Index Coronary stent thrombosis (n = 59) | |
| Asynergy of the LV lower wall | NS |
| Enlargement of the chambers of the heart | 0.64 |
| Mitral regurgitation | 0.30 |
| LV contractile function | 0.59 |
| Atherosclerosis BCA | NS |
| Intimal seal | 0.63 |
| Ascending aortic diameter | NS |
| Intima-media complex | NS |
| LV end systolic dimension | NS |
| Ejection fraction | 0.23 |
Conclusion
Echocardiography is less informative in terms of predicting the risk of coronary stent thrombosis in the early postoperative period than laboratory parameters. The developed model for predicting the likelihood of coronary stent thrombosis in the early postoperative period with a prediction accuracy of 98.7% can be recommended for use in clinical practice.