Recurrent acute stent thrombosis due to allergic reaction secondary to clopidogrel therapy

Area of Science:

• Cardiology
• Pharmacology
• Interventional Cardiology

Background:

• Antiplatelet therapy, particularly dual antiplatelet therapy (DAPT) with aspirin and clopidogrel, significantly reduces mortality after percutaneous coronary intervention (PCI).
• DAPT is a cornerstone of pharmacotherapy in the invasive cardiology era, crucial for preventing ischemic events.
• Maintaining DAPT is mandatory, but rare adverse events may necessitate cessation of one agent.

Observation:

• This case report describes a patient experiencing recurrent acute stent thrombosis.
• The stent thrombosis was directly linked to a clopidogrel-induced allergic reaction.
• The patient required careful therapeutic considerations due to this adverse event.

Findings:

• Clopidogrel allergy can precipitate acute stent thrombosis, a severe complication.
• Recurrent stent thrombosis occurred despite standard antiplatelet therapy protocols.
• Management required addressing the specific allergic reaction to clopidogrel.

Implications:

• Highlights the importance of recognizing and managing drug-induced allergies in DAPT.
• Suggests the need for alternative antiplatelet strategies in patients with clopidogrel hypersensitivity.
• Underscores the complexity of balancing antithrombotic efficacy with potential adverse drug reactions in interventional cardiology.