title: Subacute stent thrombosis owing to complete clopidogrel resistance successfully managed with prasugrel.
abstract: This report describes a case of an acute anterior myocardial infarction secondary to subacute stent thrombosis of a drug-eluting stent within the proximal segment of the left anterior descending artery (LAD) 5 days after percutaneous transluminal coronary angioplasty and stenting (PCI). The patient was initially managed with conventional dual-antiplatelet therapy (aspirin and clopidogrel) and was subsequently found to have complete absence of adenosine diphosphate (ADP) receptor P2Y12 receptor inhibition. Following additional PCI of the LAD and substitution of clopidogrel for the thienopyridine prasugrel, therapeutic platelet inhibition was achieved without recurrence of stent thrombosis.
authors: Division of Cardiovascular Medicine, University of Louisville School of Medicine, Louisville, Kentucky, USA.
authors: Michael P
authors: MP
authors: Flaherty
authors: Peter V
authors: PV
authors: Johnston
authors: Jeffrey J
authors: JJ
authors: Rade
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects; D056988:Anterior Wall Myocardial Infarction / Q000175:diagnosis / Q000209:etiology*; D000077144:Clopidogrel; D000075202:Contraindications; D003324:Coronary Artery Disease / Q000628:therapy; D004351:Drug Resistance; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010879:Piperazines / Q000494:pharmacology / Q000627:therapeutic use*; D010974:Platelet Aggregation / Q000187:drug effects; D010975:Platelet Aggregation Inhibitors / Q000494:pharmacology; D000068799:Prasugrel Hydrochloride; D058925:Receptors, Purinergic P2Y12 / Q000187:drug effects; D013876:Thiophenes / Q000494:pharmacology / Q000627:therapeutic use*; D013927:Thrombosis / Q000150:complications*; D013988:Ticlopidine / Q000031:analogs & derivatives* / Q000494:pharmacology; D017211:Treatment Failure; D016896:Treatment Outcome
chemical_list: C548576:P2RY12 protein, human; D010879:Piperazines; D010975:Platelet Aggregation Inhibitors; D058925:Receptors, Purinergic P2Y12; D013876:Thiophenes; D000077144:Clopidogrel; D000068799:Prasugrel Hydrochloride; D013988:Ticlopidine