title: Acute and subacute stent thrombosis in a patient with clopidogrel resistance: a case report.
abstract: Drug-eluting stents (DES) are considered the treatment of choice for most patients with obstructive coronary artery disease when percutaneous intervention (PCI) is feasible. However, stent thrombosis seems to occur more frequently with DES and occasionally is associated with resistance to anti-platelet drugs. We have experienced a case of recurrent stent thrombosis in a patient with clopidogrel resistance. A 63-year-old female patient suffered from acute myocardial infarction and underwent successful PCI of the left anterior descending coronary artery (LAD) with two DESs. She was found to be hyporesponsive to clopidogrel and was treated with triple anti-platelet therapy (aspirin 100 mg, clopidogrel 75 mg, and cilostazol 200 mg daily). Three days after discharge, she developed chest pain and was again taken to the cardiac catheterization laboratory, where coronary angiography (CAG) showed total occlusion of the mid-LAD where the stent had been placed. After intravenous administration of a glycoprotein IIb/IIIa inhibitor, balloon angioplasty was performed, resulting in Thrombolysis In Myocardial Infarction (TIMI) III antegrade flow. The next day, however, she complained of severe chest pain, and the electrocardiogram showed marked ST-segment elevation in V1-V6, I, and aVL with complete right bundle branch block. Emergent CAG revealed total occlusion of the proximal LAD due to stent thrombosis. She was successfully treated with balloon angioplasty and was discharged with triple anti-platelet therapy.
authors: The Heart Research Center of Chonnam National University Hospital, Gwangju, Korea.
authors: Sung Soo
authors: SS
authors: Kim
authors: Myung Ho
authors: MH
authors: Jeong
authors: Hyun-Kuk
authors: HK
authors: Kim
authors: Soo Young
authors: SY
authors: Bae
authors: Kyoung Ho
authors: KH
authors: Ryu
authors: Kyung Hun
authors: KH
authors: Cho
authors: Min Chul
authors: MC
authors: Kim
authors: Keun Ho
authors: KH
authors: Park
authors: Doo Sun
authors: DS
authors: Sim
authors: Young Joon
authors: YJ
authors: Hong
authors: Ju Han
authors: JH
authors: Kim
authors: Youngkeun
authors: Y
authors: Ahn
authors: Jung Chaee
authors: JC
authors: Kang