A case report of simultaneous thrombosis of two coronary artery stents in association with clopidogrel resistance.
Despite aggressive antiplatelet therapy in the setting of PCI, the incidence of acute stent thrombosis remains approximately 0.5-2%. We report a patient with simultaneous thrombosis of two drug-eluting coronary artery stents, suggesting a systemic thrombotic state. Evaluation by optical platelet aggregometry revealed clopidogrel resistance, which was overcome at a higher drug dose. We aim to highlight the potential utility of platelet function analysis to guide therapy for patients in whom inadequate antiplatelet therapy may have catastrophic clinical outcomes.
Lee
Jin Sun
JS
University of North Carolina at Chapel Hill, School of Medicine, USA. jin_lee@med.unc.edu
Dunn
Steven P
SP
Marshall
Helen M
HM
Cohen
Mauricio G
MG
Smyth
Susan S
SS
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D000077144:Clopidogrel; D023921:Coronary Stenosis / Q000628:therapy; D003328:Coronary Thrombosis / Q000209:etiology* / Q000503:physiopathology; D004351:Drug Resistance / Q000187:drug effects; D006801:Humans; D008297:Male; D010974:Platelet Aggregation / Q000187:drug effects; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D010979:Platelet Function Tests; D015607:Stents / Q000009:adverse effects*; D013988:Ticlopidine / Q000031:analogs & derivatives* / Q000627:therapeutic use
D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine