Acute Stent Failure, Risks of MI or Death

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Acute Stent Thrombosis frequently results in myocardial infarction (up to 80% of cases) with reported mortality rates between 30 and 45%. 

In contrast, Coronary Artery Bypass Graft occlusion may become apparent with recurrent angina, which then may lead to repeat revascularization. This effect is well known from the literature and did indeed translate into increased rates of myocardial infarction and cardiac death in the SYNTAX trial:

“CABG remains the standard of care for patients with three-vessel or left main coronary artery disease”(2)

While stenting is of course not responsible for the Atherosclerosis, it causes severe local damage to the artery involved; the result an inflammatory reaction that involves the area that is stented as well as a zone up – and down stream of the artery, thus the 10-15% yearly failure rate/stent.

In essence a stent produces a new disease and to prevent the built-in complications, all those drugs are given to suppress the inflammatory response. An acute event is usually the result of plaque hemorrhage with acute occlusion of the artery involved, which is what probably happened. He died before an examination of the heart would have shown actual necrosis. 

 

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