Abstract
A 65-year-old man developed 3-vessel stent thrombosis after percutaneous coronary
intervention with aspirin and clopidogrel. Platelet tests revealed clopidogrel resistance,
which resolved after changing clopidogrel to ticagrelor. Although routine platelet
tests after stenting are not recommended, these tests may be considered to identify
the cause of stent thrombosis and modify antiplatelet therapy.
Résumé
Un homme de 65 ans a développé une thrombose de l'endoprothèse au niveau de trois
vaisseaux après une intervention coronarienne percutanée sous aspirine et clopidogrel.
Les tests de la fonction plaquettaire ont révélé une résistance au clopidogrel, qui
s'est résolue après remplacement du clopidogrel par le ticagrelor. Bien que les tests
de la fonction plaquettaire de routine après la pose d'une endoprothèse ne soient
pas recommandés, ces tests peuvent être envisagés pour identifier la cause de la thrombose
liée à l'endoprothèse et modifier le traitement antiplaquettaire.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Canadian Journal of CardiologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Different prognostic significance of high on-treatment platelet reactivity as assessed by the VerifyNow P2Y12 assay after coronary stenting in patients with and without acute myocardial infarction.J Am Coll Cardiol Intv. 2012; 5: 259-267
- Platelet function monitoring to adjust antiplatelet therapy in elderly patients stented for an acute coronary syndrome (ANTARCTIC): an open-label, blinded-endpoint, randomised controlled superiority trial.Lancet. 2016; 388: 2015-2022
- A genotype-guided strategy for oral P2Y12 inhibitors in primary PCI.N Engl J Med. 2019; 381: 1621-1631
- Effect of genotype-guided oral P2Y12 inhibitor selection vs conventional clopidogrel therapy on ischemic outcomes after percutaneous coronary intervention: the TAILOR-PCI randomized clinical trial.JAMA. 2020; 324: 761-771
- Stent thrombosis risk over time on the basis of clinical presentation and platelet reactivity: analysis from ADAPT-DES.J Am Coll Cardiol Intv. 2021; 14: 417-427
Article info
Publication history
Published online: March 25, 2021
Accepted:
March 19,
2021
Received:
February 5,
2021
Footnotes
See page 1280 for disclosure information.
Identification
Copyright
© 2021 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
