title: Failure of high-dose clopidogrel in recurrent stent thrombosis.
abstract: This case report describes recurrent drug-eluting stent thrombosis with documented laboratory hyporesponsiveness to clopidogrel. The use of escalating doses of clopidogrel prevented subsequent episodes, but the patient developed gastrointestinal intolerance and diffuse cutaneous reaction, which resolved completely with prasugrel. Impressively, prasugrel 10 mg daily achieved an even lower vasodilator-stimulated phosphoprotein platelet reactivity index compared to clopidogrel 300 mg daily. Our case highlights the importance of alternative P2Y12 receptor antagonists for patients receiving drug-eluting stents.
authors.affiliation: Yong Loo Lin School of Medicine, Dean's Office (Undergraduate Education), Singapore. universityliyiding@gmail.com
authors.forename: Yiding
authors.initials: Y
authors.lastname: Li
authors.forename: Mark Y
authors.initials: MY
authors.lastname: Chan
mesh_terms: D015906:Angioplasty, Balloon, Coronary; D000077144:Clopidogrel; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy; D010879:Piperazines / Q000627:therapeutic use; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage*; D000068799:Prasugrel Hydrochloride; D013876:Thiophenes / Q000627:therapeutic use; D013927:Thrombosis / Q000188:drug therapy*; D013988:Ticlopidine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D017211:Treatment Failure
chemical_list: D010879:Piperazines; D010975:Platelet Aggregation Inhibitors; D013876:Thiophenes; D000077144:Clopidogrel; D000068799:Prasugrel Hydrochloride; D013988:Ticlopidine