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Acute and Subacute Stent Thrombosis in a Patient With Clopidogrel Resistance: A Case Report
- Source :
- Korean Circulation Journal
- Publication Year :
- 2009
- Publisher :
- The Korean Society of Cardiology, 2009.
-
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.
- Subjects :
- medicine.medical_specialty
medicine.medical_treatment
Case Report
Chest pain
Coronary artery disease
Internal medicine
Angioplasty
Internal Medicine
medicine
Myocardial infarction
cardiovascular diseases
Cardiac catheterization
business.industry
Stent
Thrombosis
Clopidogrel
medicine.disease
Surgery
surgical procedures, operative
Cardiology
Stents
medicine.symptom
Cardiology and Cardiovascular Medicine
business
TIMI
medicine.drug
Subjects
Details
- Language :
- English
- ISSN :
- 17385555 and 17385520
- Volume :
- 39
- Issue :
- 10
- Database :
- OpenAIRE
- Journal :
- Korean Circulation Journal
- Accession number :
- edsair.doi.dedup.....31e1cfcdc131d410d1cf6fe36b1ae0a7