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WP 4 - Performing a multi-stranded characterisation of patients with late ST

As a result of the current anti-platelet strategies, late ST following both BMS and DES implantation is a relatively rare event. Because of this, it is impossible to investigate late ST clinically using single-centre approaches. Furthermore, given the low event rate, we estimate that a prospective cohort study would need to enrol, comprehensively investigate (including imaging evaluation) and follow in the region of 50,000 patients in order that approximately 500 patients with subsequent late stent thrombosis might be captured. Consequently, it is our belief that in order to address this shortcoming, a multi-centre case-control study is the best method to clinically address the issue of late ST.

Therefore, the fourth specific objective of PRESTIGE will be to coordinate the establishment of a pan-European stent thrombosis registry the PRESTIGE Registry through a collaborative network of centres from Central, Southern and Eastern Continental Europe and the UK. Over a period of 4 years, PRESTIGE Registry is expected to recruit at least 500 patients presenting with late ST as well as 1,000 matched control patients. All patients with late ST recruited in PRESTIGE will undergo a multi-stranded analysis, including an in-depth description of patient-demographic and procedure-related factors, analysis of genetic and bio-markers, platelet function testing, histopathologic analyses of the thrombus (retrieved from the involved coronary artery) and intracoronary imaging of the involved segment of the coronary artery using optical coherence tomography (OCT) and intravascular ultrasound (IVUS).

The PRESTIGE Registry will be established using a multi-access, code word protected website. The large dataset of the PRESTIGE Registry will (a) provide important insights into the prevalence of inadequate response to anti-platelet therapy, (b) help to identify genes leading to late stent thrombosis, and (c) most importantly lead to the identification of surrogate parameters provided by intracoronary imaging that are associated with a high risk of late ST. An optimized identification of patients at risk to develop late ST will be the prerequisite for the development of a more individualized anti-thrombotic therapy in the future.

WP4 Leader: Prof. Dr. W. Desmet
Co-Leader: Prof. Dr A. Gershlick

Contact

Prof. Dr Adnan Kastrati
Project Coordinator
German Heart Centre Munich
TU Munich

Per Larsen
Project Manager
German Heart Centre Munich
TU Munich

Dr Hans Sawade
Dissemination
neoplas GmbH