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Published on: December 3, 2020
Successful clopidogrel desensitization after drug-eluting stent implantation
1Department of Pharmacy, Forsyth Medical Center, Winston-Salem, North Carolina 27103, USA.
The Journal of Invasive Cardiology
|March 5, 2009
Summary
A patient experienced a skin rash after starting ticlopidine following a myocardial infarction. A modified desensitization protocol successfully enabled the patient to tolerate clopidogrel therapy.
Area of Science:
- Cardiology
- Pharmacology
Background:
- A 55-year-old male presented with non-ST-elevation myocardial infarction (NSTEMI).
- Percutaneous coronary intervention was performed with paclitaxel-eluting and bare-metal stents.
- The patient had a history of clopidogrel-associated skin rash.
Observation:
- Ticlopidine was initiated due to clopidogrel intolerance.
- The patient developed pruritus and a maculopapular rash within one day of ticlopidine initiation.
- This indicated a potential hypersensitivity reaction to ticlopidine.
Findings:
- A modified clopidogrel desensitization protocol was successfully implemented.
- The patient was able to tolerate clopidogrel therapy after desensitization.
Implications:
- This case highlights the challenges of antiplatelet therapy in patients with hypersensitivity reactions.
- Successful desensitization offers an alternative strategy for managing patients requiring dual antiplatelet therapy.
- Further research into modified desensitization protocols for thienopyridine hypersensitivity is warranted.
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