Korean Circulation Journal

The Korean Society of Cardiology (대한심장학회)
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Successful Prasugrel Rescue Therapy in Clopidogrel Resistant Patients Who Had Recurrent Stent Thrombosis of Drug-Eluting-Stent: The Role of Prasugrel in Clopidogrel Nonresponders

  • Lee, Seung-Hyun (Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine) ;
  • Kim, Byeong-Keuk (Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine) ;
  • Oh, Jaewon (Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine) ;
  • Park, Jin Su (Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine) ;
  • Lee, Dong-Jun (Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine) ;
  • Lee, Han-Cheol (Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine) ;
  • Kim, Jin Ho (Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine) ;
  • Hong, Myeong-Ki (Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine)
  • Published : 2013.05.30
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Abstract

Stent thrombosis is a very serious problem after drug-eluting stent (DES) implantation even though its incidence is about or less than 1%. As the clopidogrel resistance is expected to play an important role in the occurrence of stent thrombosis, new anti-platelet agents overcoming this issue can give us another choice. We experienced a case of a 58-year-old male with successful prasugrel rescue therapy in a patient with clopidogrel resistance who had recurrent stent thrombosis following DES implantation.

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References

  1. Daemen J, Wenaweser P, Tsuchida K, et al. Early and late coronary stent thrombosis of sirolimus-eluting and paclitaxel-eluting stents in routine clinical practice: data from a large two-institutional cohort study. Lancet 2007;369:667-78. https://doi.org/10.1016/S0140-6736(07)60314-6
  2. Honda Y, Fitzgerald PJ. Stent thrombosis: an issue revisited in a changing world. Circulation 2003;108:2-5. https://doi.org/10.1161/01.CIR.0000075929.79964.D8
  3. Antman EM, Wiviott SD, Murphy SA, et al. Early and late benefits of prasugrel in patients with acute coronary syndromes undergoing percutaneous coronary intervention: a TRITON-TIMI 38 (TRial to Assess Improvement in Therapeutic Outcomes by Optimizing Platelet InhibitioN with Prasugrel-Thrombolysis In Myocardial Infarction) analysis. J Am Coll Cardiol 2008;51:2028-33. https://doi.org/10.1016/j.jacc.2008.04.002
  4. Angiolillo DJ, Fernandez-Ortiz A, Bernardo E, et al. Identification of low responders to a 300-mg clopidogrel loading dose in patients undergoing coronary stenting. Thromb Res 2005;115:101-8. https://doi.org/10.1016/j.thromres.2004.07.007
  5. Gurbel PA, Tantry US. Drug insight: Clopidogrel nonresponsiveness. Nat Clin Pract Cardiovasc Med 2006;3:387-95. https://doi.org/10.1038/ncpcardio0602
  6. Serebruany VL, Steinhubl SR, Berger PB, Malinin AI, Bhatt DL, Topol EJ. Variability in platelet responsiveness to clopidogrel among 544 individuals. J Am Coll Cardiol 2005;45:246-51. https://doi.org/10.1016/j.jacc.2004.09.067
  7. Wright RS, Anderson JL, Adams CD, et al. 2011 ACCF/AHA focused update incorporated into the ACC/AHA 2007 Guidelines for the Management of Patients with Unstable Angina/Non-ST-Elevation Myocardial Infarction: a report of the American College of Cardiology Foundation/ American Heart Association Task Force on Practice Guidelines developed in collaboration with the American Academy of Family Physicians, Society for Cardiovascular Angiography and Interventions, and the Society of Thoracic Surgeons. J Am Coll Cardiol 2011;57:e215-367.
  8. Price MJ, Berger PB, Teirstein PS, et al. Standard- vs high-dose clopidogrel based on platelet function testing after percutaneous coronary intervention: the GRAVITAS randomized trial. JAMA 2011;305:1097-105. https://doi.org/10.1001/jama.2011.290
  9. Douglas JS Jr, Holmes DR Jr, Kereiakes DJ, et al. Coronary stent restenosis in patients treated with cilostazol. Circulation 2005;112:2826-32. https://doi.org/10.1161/CIRCULATIONAHA.104.530097
  10. Lee SW, Park SW, Hong MK, et al. Triple versus dual antiplatelet therapy after coronary stenting: impact on stent thrombosis. J Am Coll Cardiol 2005;46:1833-7. https://doi.org/10.1016/j.jacc.2005.07.048
  11. Rehmel JL, Eckstein JA, Farid NA, et al. Interactions of two major metabolites of prasugrel, a thienopyridine antiplatelet agent, with the cytochromes P450. Drug Metab Dispos 2006;34:600-7. https://doi.org/10.1124/dmd.105.007989
  12. Wiviott SD, Braunwald E, McCabe CH, et al. Prasugrel versus clopidogrel in patients with acute coronary syndromes. N Engl J Med 2007;357:2001-15. https://doi.org/10.1056/NEJMoa0706482
  13. Jernberg T, Payne CD, Winters KJ, et al. Prasugrel achieves greater inhibition of platelet aggregation and a lower rate of non-responders compared with clopidogrel in aspirin-treated patients with stable coronary artery disease. Eur Heart J 2006;27:1166-73. https://doi.org/10.1093/eurheartj/ehi877