Subacute thrombosis of two stents as a cause of acute myocardial infarction


Authors: F. Roháč ;  L. Lisá ;  P. Toušek
Authors‘ workplace: III. Interní-kardiologická klinika Fakultní nemocnice Královské Vinohrady a 3. lékařská fakulta ;  Univerzity Karlovy, Praha ;  Přednosta: Prof. MUDr. Petr Widimský, DrSc., FESC.
Published in: Prakt. Lék. 2009; 89(1): 40-42
Category: Case Report

Overview

This case describes a patient with a history of chronic coronary artery disease and its acute manifestation of myocardial infarction (MI) who developed stent thrombosis as a result of premature cessation of dual antiplatelet therapy. These days MI is usually treated with coronary intervention using stents. During stent delivery, dual antiplatelet medications such as acetylsalicylic acid (ASA) and thienopyridins (clopidogrel, ticlopidin) are used to reduce stent thrombosis. Cessation of this therapy dramatically increases the risk of stent thrombosis. The most commonly used thienopyridine (clopidogrel) is not completely covered by health insurance, which may lead to premature cessation of this therapy.

Key words:
coronary stent, stent thrombosis, coronary intervention.


Sources

1. Kuchulakanti, P.K., Chu, W.W., Torguson, R. et al. Correlates and long-term outcomes of angiographically proven stent thrombosis with sirolimus- and paclitaxel-eluting stents. Circulation 2006, 113, p. 1108-1113.

2. Airoldi, F., Colombo, A., Morici, N. et al. Incidence and predictors of drug-eluting stent thrombosis during after discontinuation of thienopyridine treatement. Circulation 2007, 116, p. 745-754.

3. Mauri, L., Hsieh, W.H., Massaro, J.M. et al. Stent thrombosis in randomized clinical trials of drug-eluting stents. NEJM 2007, 356, p. 1020-1029.

4. Roiron, C., Sanchez, P., Bouzamondo, A. et al. Drug-eluting stents: an updated metaanalysis of randomized controlled trials. Heart, 2006, 92, p. 641-649.

5. Machecourt, J., Danchin, N., Lablanche, J.M. et al. Risk factors for stent thrombosis after implantation of sirolimus-eluting stents in diabetic and nondiabetic patients: the EVASTENT matched-cohort registry. J. Am. Coll. Cardiol. 2007, 50, p. 501-508.

6. Cheneau, E., Leborgne, L., Mintz, G.S. et al. Predictors of subacute stent thrombosis. Circulation 2003, 108, p. 43-47.

7. Bavry, A.A., Bhatt, D.L. Appropriate use of drug-eluting stents: balancing the reduction in restenosis with the concern of late thrombosis. Lancet 2008, 371, p. 2134-2143.

Labels
General practitioner for children and adolescents General practitioner for adults
Login
Forgotten password

Don‘t have an account?  Create new account

Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account