Very late drug-eluting stent thrombosis in a patient with an INR of 4.4.
Duration of dual antiplatelet therapy after drug-eluting stent implantation is still an important issue awaiting a definite answer. A 50-year-old male patient was admitted with acute-onset chest pain and was diagnosed to have acute anterior myocardial infarction due to very late stent thrombosis. He had a 38-month history of two sirolimus-eluting stent implantation in the proximal left anterior descending (LAD) coronary artery. He had been on warfarin along with clopidogrel 75 mg/day until he decided to cease clopidogrel before a minor dental procedure 10 days before. Findings of physical examination and laboratory tests were normal except for an INR value of 4.4. After a loading dose of 300 mg clopidogrel, he was immediately taken to the catheterization laboratory. Angiography of the left system showed total occlusion of the proximal LAD with a thrombus at the level of the proximal stent. He was successfully revascularized without any complication and was discharged free of symptoms.
Department of Cardiology, Ankara University. basarcandemir@yahoo.com
Başar
B
Candemir
Sadi
S
Güleç
Aydan Ongun
AO
Ozdemir
Deniz
D
Kumbasar
D015906:Angioplasty, Balloon, Coronary; D003328:Coronary Thrombosis / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D006801:Humans; D019934:International Normalized Ratio; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects*; D013997:Time Factors; D016896:Treatment Outcome
D010975:Platelet Aggregation Inhibitors