{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T19:30:42Z","timestamp":1786476642742,"version":"build-2736575974"},"reference-count":100,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T00:00:00Z","timestamp":1774828800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T00:00:00Z","timestamp":1774828800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Stent thrombosis (ST) remains a rare but potentially life\u2010threatening complication of percutaneous coronary intervention (PCI), associated with high rates of myocardial infarction and mortality. Despite advances in stent technology and antithrombotic therapy, its multifactorial pathophysiology and optimal management remain challenging.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a narrative review of the current literature focusing on the pathophysiological mechanisms, clinical predictors, and contemporary management strategies of ST. Particular attention was given to stent\u2010related, pharmacological, and patient\u2010related factors, as well as emerging therapeutic approaches and preventive strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>ST arises from the complex interplay between mechanical factors (e.g., stent malapposition, underexpansion, and neoatherosclerosis), pharmacological aspects (e.g., premature discontinuation or inadequate response to dual antiplatelet therapy), and patient\u2010related conditions, including hypercoagulability and systemic inflammation. In the acute setting, prompt PCI with restoration of coronary flow remains the cornerstone of treatment, while intravascular imaging plays a key role in identifying underlying mechanisms and optimizing outcomes. Preventive strategies rely on procedural optimization, appropriate antithrombotic therapy, and careful patient selection. New\u2010generation drug\u2010eluting stents and imaging\u2010guided PCI have reduced ST incidence, whereas emerging approaches\u2014including drug\u2010coated balloons, subcutaneous antiplatelet agents, and anti\u2010inflammatory therapies\u2014represent promising adjunctive strategies, although ST\u2010specific benefits are not yet fully established.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>ST is a multifactorial complication requiring an integrated approach combining optimized PCI techniques, tailored antithrombotic therapy, and careful risk stratification. Ongoing advances in device technology and pharmacological treatments, along with a growing understanding of inflammatory pathways, may further improve prevention and clinical outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/clc.70286","type":"journal-article","created":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T14:42:11Z","timestamp":1774881731000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Stent Thrombosis: A Narrative Review From Pathophysiology to Therapy"],"prefix":"10.1002","volume":"49","author":[{"given":"Emanuele","family":"Cecchi","sequence":"first","affiliation":[{"name":"Department of Clinical and Experimental Medicine University of Florence, School of Human and Health Science Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea Grasso","family":"Granchietti","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine University of Florence, School of Human and Health Science Florence Italy"},{"name":"General Cardiology Unit, Department of Cardiac Thoracic and Vascular Medicine Azienda Ospedaliero\u2010Universitaria Careggi Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2401-6401","authenticated-orcid":false,"given":"Ruggero","family":"Mazzotta","sequence":"additional","affiliation":[{"name":"General Cardiology Unit, Department of Cardiac Thoracic and Vascular Medicine Azienda Ospedaliero\u2010Universitaria Careggi Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-6011-0710","authenticated-orcid":false,"given":"Manuel","family":"Garofalo","sequence":"additional","affiliation":[{"name":"General Cardiology Unit, Department of Cardiac Thoracic and Vascular Medicine Azienda Ospedaliero\u2010Universitaria Careggi Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgia","family":"Panichella","sequence":"additional","affiliation":[{"name":"General Cardiology Unit, Department of Cardiac Thoracic and Vascular Medicine Azienda Ospedaliero\u2010Universitaria Careggi Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Iula","sequence":"additional","affiliation":[{"name":"General Cardiology Unit, Department of Cardiac Thoracic and Vascular Medicine Azienda Ospedaliero\u2010Universitaria Careggi Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2145-6555","authenticated-orcid":false,"given":"Francesca Maria","family":"Di Muro","sequence":"additional","affiliation":[{"name":"The Zena and Michael A. 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