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Open Access In-Stent Thrombosis after Antiplatelet Therapy Conversion while Awaiting Coronary Bypass

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This article is Open Access under the terms of the Creative Commons CC BY-NC licence.

In-stent thrombosis (IST) is a rare yet dangerous complication that may occur despite optimized coronary intervention in the cardiac catheterization laboratory. This is a case of an 81-year-old man who presented with ST-elevation myocardial infarction. Right coronary artery (RCA) occlusion was suspected. RCA angiography and percutaneous coronary intervention were performed. Complicated left coronary artery disease was subsequently discovered. Per cardiothoracic surgeon request, the patient was transitioned from ticagrelor to clopidogrel therapy in preparation for coronary artery bypass grafting. The patient experienced IST the day before surgery while receiving clopidogrel. We examine this case, which highlights the complexity of antiplatelet therapy choice and the role of genetic testing in evaluation of IST risk.

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Keywords: Acute myocardial infarction/ST-elevation myocardial infarction; antiplatelet therapy; drug-eluting stent; drugs/pharmacotherapy; genetics; platelet biology

Document Type: Case Report

Affiliations: Division of Cardiovascular Medicine, University of Florida College of Medicine, Gainesville, Florida, USA

Publication date: November 1, 2020

This article was made available online on September 15, 2020 as a Fast Track article with title: "In-Stent Thrombosis after Antiplatelet Therapy Conversion while Awaiting Coronary Bypass".

More about this publication?
  • Cardiovascular Innovations and Applications (CVIA) publishes focused articles and original clinical research that explore novel developments in cardiovascular disease, effective control and rehabilitation in cardiovascular disease, and promote cardiovascular innovations and applications for the betterment of public health globally. The journal publishes basic research that has clinical applicability in order to promote timely communication of the latest insights relating to coronary artery disease, heart failure, hypertension, cardiac arrhythmia, prevention of cardiovascular disease with a heavy emphasis on risk factor modification. Cardiovascular Innovations and Applications is the official journal of the Great Wall International Congress of Cardiology (GW-ICC). It aims to continue the work of the GW-ICC by providing a global scientific communication platform for cardiologists that bridges East and West.

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