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ARRIVE Registry Analysis Identifies Predictors of Stent Thrombosis,in Real-World Use of Drug-Eluting Stents

ts remained on aspirin while 71.5 percent continued with antiplatelet therapy. At two years (ARRIVE 1 patients only), 92.2 percent were on aspirin and 58.5 percent remained on antiplatelet therapy. Rates of stent thrombosis in the pooled patient set were 1.0 percent from 0-30 days, 0.3 percent from 31-180 days, and 0.4 percent from six months to one year. Stent thrombosis for ARRIVE 1 patients from one to two years (very late stent thrombosis or VLST) was 0.7 percent. These rates are similar to findings of previous studies and align well with patient and lesion risk profiles.

The analysis showed that discontinuation of antiplatelet therapy before six months is a significant predictor of stent thrombosis at both one and two years. Information available from 13 of 16 VLST patients showed that 30.8 percent of these patients had discontinued dual antiplatelet therapy within seven days of a VLST event. Other statistically significant predictors of stent thrombosis up to one year include several lesion characteristics, including long lesions, multiple stents, calcified lesions and small vessels, as well as patient-related factors such as smoking and congestive heart failure. Significant stent thrombosis predictors from one to two years consist of more biologic factors, including failed brachytherapy, chronic total occlusions, prior myocardial infarction and age.

"The ARRIVE data indicate that antiplatelet therapy is an important factor relating to the occurrence of stent thrombosis in DES patients," said Dr. Dobies, Director, Genesys Heart Institute, Grand Blanc, Michigan. "Other significant predictors change from one to two years, suggesting differences in pathophysiology that may require additional study."

"Our extensive ARRIVE registries provide valuable insight into the key predictors for stent thrombosis in real-world DES use," said Paul LaViolette, Chief Operating Officer of Boston Scientific. "Determination of baseline predictors may help ident
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