Display options
Cite
Middlebrooks EH, Panda M. Multiple recurrent stent thrombosis in a patient with coexisting clopidogrel resistance and increased anticardiolipin antibodies: a case report. Case Rep Med. 2010;2010:974149doi: 10.1155/2010/974149.
Middlebrooks, E. H., & Panda, M. (2010). Multiple recurrent stent thrombosis in a patient with coexisting clopidogrel resistance and increased anticardiolipin antibodies: a case report. Case reports in medicine, 2010974149. https://doi.org/10.1155/2010/974149
Middlebrooks, Erik H, and Panda, Mukta. "Multiple recurrent stent thrombosis in a patient with coexisting clopidogrel resistance and increased anticardiolipin antibodies: a case report." Case reports in medicine vol. 2010 (2010): 974149. doi: https://doi.org/10.1155/2010/974149
Middlebrooks EH, Panda M. Multiple recurrent stent thrombosis in a patient with coexisting clopidogrel resistance and increased anticardiolipin antibodies: a case report. Case Rep Med. 2010;2010:974149. doi: 10.1155/2010/974149. Epub 2010 Jun 13. PMID: 20592997; PMCID: PMC2892706.
Copy Download .nbib Format: NLM
Share it on

Case Rep Med. 2010;2010:974149. doi: 10.1155/2010/974149. Epub 2010 Jun 13.

Multiple recurrent stent thrombosis in a patient with coexisting clopidogrel resistance and increased anticardiolipin antibodies: a case report.

Case reports in medicine

Erik H Middlebrooks, Mukta Panda

Affiliations

  1. College of Medicine, University of Tennessee, Chattanooga, TN 37403, USA.

PMID: 20592997 PMCID: PMC2892706 DOI: 10.1155/2010/974149

Abstract

The antiphospholipid syndrome (APS) is a common cause of both arterial and venous thrombosis. While studies exist demonstrating the role of APS in coronary artery bypass graft failure, its role in stent thrombosis is less clearly documented. Also, a literature search of PubMed did not reveal any articles regarding the coexistence of clopidogrel resistance and APS despite increasing awareness of resistance to clopidogrel treatment. We present a case of a 59-year-old male having recurrent myocardial infarction after subacute restenosis of multiple drug-eluting stents despite anticoagulant therapy. The patient had in-stent thrombosis of seven drug-eluting stents in a course of eight days. He was subsequently found to have mild elevation of IgG anticardiolipin (aCL) antibody titers and resistance to clopidogrel. Long-term anticoagulation with a combination of low-molecular-weight heparin, clopidogrel, and aspirin has been effective. While the patient's aCL titer level was not elevated above the level required by the current diagnostic criteria for APS, we believe that this patient suffers from the antiphospholipid syndrome. We will discuss some of the controversies surrounding the diagnosis of APS as well as appropriate treatment and recognition of the coexistence of APS and clopidogrel resistance in patients with stent thrombosis.

References

  1. Am Heart J. 2008 Dec;156(6):1080-1088.e1 - PubMed
  2. Kaohsiung J Med Sci. 2003 Apr;19(4):177-82 - PubMed
  3. Clin Exp Rheumatol. 1997 Sep-Oct;15(5):541-4 - PubMed
  4. J Thromb Haemost. 2007 Jan;5(1):75-81 - PubMed
  5. Eur J Clin Invest. 2006 Dec;36(12):839-43 - PubMed
  6. Circulation. 2005 Mar 8;111(9):1153-9 - PubMed
  7. Hematol Oncol Clin North Am. 2003 Feb;17(1):115-47 - PubMed
  8. Lupus. 2003;12(4):302-7 - PubMed
  9. Int J Cardiovasc Intervent. 2003;5(1):44-6 - PubMed
  10. J Am Coll Cardiol. 2008 Apr 8;51(14):1404-11 - PubMed
  11. Hematol Oncol Clin North Am. 2008 Feb;22(1):155-74, viii - PubMed
  12. J Am Coll Cardiol. 2005 May 3;45(9):1392-6 - PubMed
  13. Ann Biol Clin (Paris). 1994;52(5):365-73 - PubMed
  14. J Thromb Haemost. 2006 Feb;4(2):295-306 - PubMed
  15. Thromb Haemost. 2008 Feb;99(2):357-62 - PubMed
  16. J Am Coll Cardiol. 2006 Nov 7;48(9):1742-50 - PubMed
  17. Rev Cardiovasc Med. 2006 Fall;7(4):244-6 - PubMed
  18. Lancet. 1986 Dec 13;2(8520):1353-7 - PubMed
  19. J Am Coll Cardiol. 2007 Jun 19;49(24):2312-7 - PubMed

Publication Types