The following is a summary of “Coronary Stent Infection: A Systematic Review of Literature,” published in the December 2023 issue of Cardiology by Ayyubi et al.
Despite its low incidence, coronary stent infection poses a severe threat to patients undergoing coronary intervention procedures.
Researchers started a retrospective study to evaluate the diagnosis, management, and outcomes of coronary stent infection.
They extensively searched electronic databases (PubMed, Embase, Cochrane Library, and Scopus) from inception until March 2023, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
The results showed 1 case series with 41 case reports, encompassing a cumulative sample size of 44 patients. Drug-eluting stents prevailed in 22 studies, bare-metal stents in 3, and a combination of both in 4 studies. Staphylococcus aureus was the identified organism in microbiological profiles. Primary outcomes showed mortality, morbidity, and recurrence rates, which were assessed. The overall mortality rate stood at 18%, highlighting the severity of coronary stent infections. Morbidity ranged from 3% to 60%, presenting complications like sepsis, heart failure, and embolic events. Recurrence rates fluctuated from 3% to 33%, accentuating the need for effective management. Treatment strategies involved antibiotics alone, with stent removal, with stent retention, and with antibiotic therapy lasting 2 weeks to 12 months. Due to limited high-quality evidence, the optimal management strategy remains to be determined, emphasizing the critical role of early diagnosis and treatment in improving outcomes.
Investigators concluded that prophylactic antibiotics during stenting procedures and increased awareness among healthcare providers were recommended to prevent coronary stent infections.