Platelet reactivity in patients with subacute stent thrombosis compared with non–stent-related acute myocardial infarction

Lev, Eli I.; Alviar, Carlos L.; Arıkan, Mehmet Erdinç; Dave, B.; Granada, Juan F.; DeLao, Timothy; Téllez, Armando; Maresh, Kelly; Kleiman, Neal S.

doi:10.1016/j.ahj.2006.10.020

Cited by 22 publications

(16 citation statements)

References 19 publications

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“…It has therefore repeatedly been suggested that platelet function in patients who develop subacute thrombotic complications should be analyzed in depth. 8,31,32 Testing of patients receiving clopidogrel has demonstrated a nonresponse rate of up to 17.5%. 33 This exceeds the rate of subacute thrombosis in our patients treated for atherosclerotic stenosis by 5.4% and in patients with stent-assisted coiling by 8.7%.…”

Section: Discussionmentioning

confidence: 99%

“…1 In contrast, stent thrombosis after coronary artery angioplasty is an important issue that has been reported on a regular basis for Ͼ10 years. [2][3][4] Furthermore, researchers in interventional cardiology have analyzed the underlying pathophysiology of stent thrombosis in depth [5][6][7][8][9] and have presented treatment options to lower the overall risk for this complication. 10 -12 Apart from that, effective treatment procedures have been reported for cases of subacute stent thrombosis after coronary angioplasty.…”

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confidence: 99%

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Subacute Stent Thrombosis in Intracranial Stenting

Riedel

Tietke

Alfke

et al. 2009

Stroke

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Background and Purpose— We sought to determine the safety of intracranial stenting with respect to subacute stent thrombosis in patients being treated with standardized antiplatelet therapy. Methods— We retrospectively evaluated the outcome of primary intracranial stenting of atherosclerotic stenoses and of stenting in coil embolization procedures in 67 patients. We focused on those cases that led to subacute stent thrombosis even though the patients had been treated with standardized antiplatelet therapy before, during, and after stent placement. Patient age ranged from 19 to 78 years. In 33 patients, stents were placed for treatment of atherosclerotic stenoses; in the remaining 34 patients, stents were placed to assist coiling of aneurysms. The patients in this study were treated between January 2003 and August 2007. Results— Of the total 67 patients initially treated successfully by intracranial stenting, 7 patients developed subacute stent thrombosis. Of these 7 patients, 3 received stent placement into the basilar artery because of an underlying stenosis; in 1 patient, a stenosis of the M1 segment of the middle cerebral artery was treated. In 3 patients, aneurysms of the anterior cerebral artery, the posterior inferior cerebellar artery, and the basilar artery were treated by stent-assisted coil embolization. In 4 of the 7 patients with subacute thrombosis, recanalization of stents by local application of recombinant tissue-type plasminogen activator was successful. Conclusions— Intracranial stenting can lead to subacute stent thrombosis, even in patients who are treated with standardized antiplatelet therapy. Such complications have been described for patients after coronary artery stenting, but to our knowledge, no one has reported on a comparable number of cases of intracranial stenting procedures. In certain clinical scenarios, local thrombolysis with recombinant tissue-type plasminogen activator is an important treatment option to deal with subacute stent thrombosis.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Subacute Stent Thrombosis in Intracranial Stenting

Riedel

Tietke

Alfke

et al. 2009

Stroke

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“…The LTA after ADP stimulation has been the most widely used test, in which low platelet response to clopidogrel is associated with poorer outcome after PCI due to increased incidence of peri-procedural myocardial injury [60][61][62], as well as of cardiovascular events at short term [28,[65][66][67] and midterm [58,69,70]. Observational data also show a higher residual platelet reactivity after clopidogrel treatment in patients with stent thrombosis [72][73][74][75][76][77] and this has been confirmed in a prospective study [78] demonstrating [3-fold increased risk of drug-eluting stent thrombosis at 6 months in the presence of impaired clopidogrel response. However, LTA presents a number of limitations, such as need for highly trained personnel, repeated centrifugations, large sample volume, length of assay time, and sub-optimal reproducibility.…”

Section: Optimal Clopidogrel Loading Dose In Patients Undergoing Pcimentioning

confidence: 99%

Contemporary issues on clopidogrel therapy

Patti

Sciascio

2009

Intern Emerg Med

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In this paper, data from available studies regarding some contemporary issues on clopidogrel therapy are analyzed. In particular, the following clinical questions have been considered and addressed: (a) Is early clopidogrel treatment needed in patients with acute coronary syndromes treated medically or undergoing percutaneous coronary intervention (PCI)? (b) What is the optimal clopidogrel loading dose in patients undergoing PCI? (c) Is pre-treatment with clopidogrel before PCI needed, or can clopidogrel loading be given in the catheter laboratory before intervention, but after coronary anatomy is known? (d) What is the optimal clopidogrel strategy in patients on chronic clopidogrel therapy undergoing PCI? (e) Does the degree of clopidogrel response influence clinical outcome in patients undergoing PCI?

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“…Lev и соавт. [46] показали, что тромбо-цитарная активность у пациентов с подострым тром-бозом стента и ИМ с подъемом ST и последующим ЧКВ выше таковой в сравнении с более стабильными па-циентами без тромбоза стента после ЧКВ. Возникает вопрос, является ли остаточная реактивность на двой-ной антитромбоцитарной терапии фактором риска по-дострого ИМ или его следствием?…”

Section: высокая реактивность тромбоцитов на фоне терапии и риски троunclassified

Antiplatelet Therapy Control: Credibility Gap or Search for New Decisions?

Grinshtein

Косинова

Grinshtein

2013

Racionalʹnaâ farmakoterapiâ v kardiologii

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Красноярский государственный медицинский университет им. проф. В.Ф. Войно-Ясенецкого 660022, Красноярск, улица Партизана Железняка, 1Рассматривают последние данные о применении функциональных тромбоцитарных тестов у пациентов c ишемической болезнью сердца после чрескожного коронарного вмешательства и их вкладе в персонализацию антитромбоцитарного лечения и снижение частоты сердечно-сосудистых катастроф. The review presents recent data on the usage of platelet functional tests in patients with ischemic heart disease after percutaneous coronary intervention and its contribution to antiplatelet therapy personalization and cardiovascular events frequency reduction.

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Platelet reactivity in patients with subacute stent thrombosis compared with non–stent-related acute myocardial infarction

Cited by 22 publications

References 19 publications

Subacute Stent Thrombosis in Intracranial Stenting

Subacute Stent Thrombosis in Intracranial Stenting

Contemporary issues on clopidogrel therapy

Antiplatelet Therapy Control: Credibility Gap or Search for New Decisions?

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