Successful Therapy With Ticagrelor in Three-Vessel Stent Thrombosis Related to Clopidogrel Resistance

Seung-Yul Lee1, Jae Young Cho1, Kyeong Ho Yun1

  • 1Regional Cardiocerebrovascular Center, Wonkwang University Hospital, Iksan, Korea.

Insights

Clopidogrel resistance caused stent thrombosis in a patient despite dual antiplatelet therapy. Switching to ticagrelor resolved the issue, suggesting tailored antiplatelet therapy may be beneficial.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Percutaneous coronary intervention (PCI) is a common procedure for coronary artery disease.
  • Dual antiplatelet therapy (DAPT) with aspirin and clopidogrel is standard post-PCI to prevent stent thrombosis.

Observation:

  • A 65-year-old male patient experienced 3-vessel stent thrombosis despite receiving aspirin and clopidogrel.
  • Platelet function testing identified resistance to clopidogrel.

Findings:

  • The patient's clopidogrel resistance resolved upon switching antiplatelet medication to ticagrelor.
  • This switch successfully managed the stent thrombosis.

Implications:

  • While routine platelet testing post-stenting is not standard, it can be valuable in refractory cases.
  • Identifying specific antiplatelet drug resistance can guide personalized therapy to prevent stent thrombosis.
  • Ticagrelor may be a viable alternative for patients exhibiting clopidogrel resistance.

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