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[Management of antiplatelet therapy: a case report]

F Carrare1, N Ferrier, G Bitar

  • 1Service de médecine interne à orientation cardiologique, département de cardiologie, centre hospitalier de Vichy, boulevard Deniere, 03200 Vichy, France.

Annales De Cardiologie Et D'Angeiologie
|October 16, 2007
PubMed

Insights

Flurbiprofen is not a suitable substitute for clopidogrel in patients undergoing surgery after angioplasty and stenting. This case highlights challenges in managing antiplatelet therapy, especially with aspirin resistance.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Management of antiplatelet therapy in patients with coronary stents undergoing surgery is complex.
  • Balancing the risk of stent thrombosis against surgical bleeding is a critical clinical challenge.

Observation:

  • A patient experienced myocardial infarction when flurbiprofen was used instead of clopidogrel prior to surgery.
  • This case prompted a literature review on managing antiplatelet treatment in patients with angioplasty and/or stents needing surgery.

Findings:

  • Flurbiprofen is not a satisfactory alternative to aspirin, even when combined with thienopyridines.
  • The management of antiplatelet treatment in this context remains delicate, with unanswered questions, particularly regarding aspirin resistance.

Implications:

  • Clinical guidelines may need re-evaluation regarding the use of non-steroidal anti-inflammatory drugs (NSAIDs) like flurbiprofen in patients with coronary stents.
  • Further research is needed to address aspirin resistance and optimize antiplatelet strategies for surgical patients with coronary stents.

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