Late stent thrombosis (> 1 year) following clopidogrel withdrawal after brachytherapy treatment: need to assess aspirin resistance?
We report on a patient presenting with late thrombosis of a stent 15 months after being treated with intracoronary brachytherapy. It occurred 17 days after clopidogrel withdrawal while maintaining treatment with aspirin. At the time of stent thrombosis, evaluation of platelet aggregation was performed, revealing a suboptimal response to aspirin. Pathophysiological insights of aspirin resistance and clinical implications are reviewed.
Jiménez-Quevedo
Pilar
P
Instituto Cardiovascular. Servicio de Cardiología Intervencionista, Hospital Clínico San Carlos, Madrid, Spain.
Angiolillo
Dominick J
DJ
Bernardo
Esther
E
Sabaté
Manel
M
D000328:Adult; D015906:Angioplasty, Balloon, Coronary; D001241:Aspirin / Q000627:therapeutic use; D019917:Blood Vessel Prosthesis Implantation; D001918:Brachytherapy; D000077144:Clopidogrel; D003131:Combined Modality Therapy; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000628:therapy; D003328:Coronary Thrombosis / Q000188:drug therapy* / Q000209:etiology* / Q000503:physiopathology; D004351:Drug Resistance / Q000187:drug effects; D006083:Graft Occlusion, Vascular / Q000188:drug therapy* / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D008297:Male; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D015607:Stents; D013988:Ticlopidine / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D013997:Time Factors
D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin