Successful clopidogrel desensitization after drug-eluting stent implantation.
A 55-year-old male was admitted with a recent non-ST-elevation myocardial infarction (NTEMI) and taken to the catheterization laboratory for further management. Culprit lesions were identified in the distal right coronary artery and ramus intermedius, requiring 2 paclitaxel-eluting stents (Taxus(R), Boston Scientific Corp., Natick, Massachusetts) and a bare-metal stent, respectively. The patient was started on ticlopidine therapy due to a history of clopidogrel- associated skin rash. One day after ticlopidine initiation, the patient developed pruritus and a maculopapular rash of the trunk area. The patient was discharged briefly on aspirin and cilostazol therapy with readmission plans for clopidogrel desensitization. A modified protocol was successfully utilized to desensitize the patient.
Kammer
Ryan T
RT
Department of Pharmacy, Forsyth Medical Center, Winston-Salem, North Carolina 27103, USA.
D015906:Angioplasty, Balloon, Coronary / Q000379:methods; D001241:Aspirin / Q000627:therapeutic use; D000077144:Clopidogrel; D003888:Desensitization, Immunologic / Q000379:methods*; D054855:Drug-Eluting Stents; D004562:Electrocardiography; D005076:Exanthema / Q000139:chemically induced; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology / Q000628:therapy*; D017239:Paclitaxel / Q000008:administration & dosage; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects / Q000276:immunology* / Q000627:therapeutic use*; D011537:Pruritus / Q000139:chemically induced; D013988:Ticlopidine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000276:immunology / Q000627:therapeutic use
D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine; D017239:Paclitaxel; D001241:Aspirin