Very late drug-eluting stent thrombosis in a patient with an INR of 4.4

Turk Kardiyol Dern Ars. 2010 Dec;38(8):561-3.

Abstract

Duration of dual antiplatelet therapy after drug-eluting stent implantation is still an important issue awaiting a definite answer. A 50-year-old male patient was admitted with acute-onset chest pain and was diagnosed to have acute anterior myocardial infarction due to very late stent thrombosis. He had a 38-month history of two sirolimus-eluting stent implantation in the proximal left anterior descending (LAD) coronary artery. He had been on warfarin along with clopidogrel 75 mg/day until he decided to cease clopidogrel before a minor dental procedure 10 days before. Findings of physical examination and laboratory tests were normal except for an INR value of 4.4. After a loading dose of 300 mg clopidogrel, he was immediately taken to the catheterization laboratory. Angiography of the left system showed total occlusion of the proximal LAD with a thrombus at the level of the proximal stent. He was successfully revascularized without any complication and was discharged free of symptoms.

Publication types

  • Case Reports

MeSH terms

  • Angioplasty, Balloon, Coronary
  • Coronary Thrombosis / diagnosis
  • Coronary Thrombosis / etiology*
  • Coronary Thrombosis / surgery
  • Drug-Eluting Stents / adverse effects*
  • Humans
  • International Normalized Ratio
  • Male
  • Middle Aged
  • Myocardial Infarction / diagnosis
  • Myocardial Infarction / etiology*
  • Myocardial Infarction / surgery
  • Platelet Aggregation Inhibitors / adverse effects*
  • Time Factors
  • Treatment Outcome

Substances

  • Platelet Aggregation Inhibitors