A case report of simultaneous thrombosis of two coronary artery stents in association with clopidogrel resistance

Abstract

SummaryDespite aggressive antiplatelet therapy in the setting of PCI, the incidence of acute stent thrombosis remains approximately 0.5-2%. We report a patient with simultaneous thrombosis of two drug-eluting coronary artery stents, suggesting a systemic thrombotic state. Evaluation by optical platelet aggregometry revealed clopidogrel resistance, which was overcome at a higher drug dose. We aim to highlight the potential utility of platelet function analysis to guide therapy for patients in whom inadequate antiplatelet therapy may have catastrophic clinical outcomes.

Simultaneous subacute stent thrombosis of two sirolimus-eluting stents in a patient treated by ReoPro, thrombus aspiration and triple anti-platelet agents

“…Simultaneous multi-vessel ST is rare, but there were some reports concerning about this [11][12][13]. However, all of the previous reports were under the dual anti-platelet regimen [12,13] or association with clopidogrel resistance [11].…”

Resistance on the Latest Oral and Intravenous P2Y12 ADP Receptor Blockers in Patients with Acute Coronary Syndromes: Fact or Myth?

“…A previous observational study [ 14 ] showed that clopidogrel resistance was present in 72.5% of patients admitted for repeated ACS, which suggests that HTPR likely plays an important role in recurrent ACS. Additionally, the phenomenon was reported as a leading cause of stent thrombosis (including left main-chain and multi-vessel stent thrombosis) in several clinical cases [ 15 , 16 , 17 , 18 , 19 ].…”