Article Sidebar

Submitted
15 November 2016
Accepted
15 November 2016
Published
15 November 2016
Download
PDF
Statistic
Read Counter : 921 Download : 1601

Main Article Content

Abstract

Protein S deficiency and antiplatelets clopidogrel resistance may uncommonly be responsible for coronary artery thrombosis. Hereby we report a patient presented with coronary disease, who had undergone PCI. However, two days later the patient was found in-stent thrombosis. Primary PCI was performed later with good result, but after 4 months evaluation with treadmill test we found significant ST depression in related region. It was suspected the patient had in-stent re-stenosis incidence. Further hematologic investigation showed that this patient had antiplatelets clopidogrel resistance and protein S deficiency. Double antiplatelet with another kind of antiplatelets and anticoagulant had given in this case. However, the remaining consideration is the choice for reperfusion strategy.

Keywords

sub-acute stent thrombosis PCI in-stent re-stenosis anti-platelets clopidogrel resistance protein S deficiency

Article Details

License

  • Folia Medica Indonesiana is a scientific peer-reviewed article which freely available to be accessed, downloaded, and used for research purposes. Folia Medica Indonesiana (p-ISSN: 2541-1012; e-ISSN: 2528-2018) is licensed under a Creative Commons Attribution 4.0 International License. Manuscripts submitted to Folia Medica Indonesiana are published under the terms of the Creative Commons License. The terms of the license are:

    Attribution ” You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.

    NonCommercial ” You may not use the material for commercial purposes.

    ShareAlike ” If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.

    No additional restrictions ” You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.

    You  are free to :

    Share ” copy and redistribute the material in any medium or format.

    Adapt ” remix, transform, and build upon the material.

How to Cite
Kurniawan, M. Z., & Pratanu, I. (2016). SUB-ACUTE STENT THROMBOSIS AND IN-STENT RESTENOSIS ASSOCIATED WITH ANTIPLATELETS CLOPIDOGREL RESISTANCE AND PROTEIN S DEFICIENCY. Folia Medica Indonesiana, 51(4), 214–220. https://doi.org/10.20473/fmi.v51i4.2949
Download Citation
Endnote/Zotero/Mendeley (RIS)
BibTeX

References

  1. Acar G, Dogan A, Altinbas A, Turker Y (2006). Recurrent acute stent thrombosis associated with protein C and S deficiencies. Int J Cardiovasc Imaging 22, 333–337
  2. Antolin RH (2004). Complications and how to deal with them. In: Kay P, Sabate M, Costa MA (eds). Cardiac Catheterization and Percutaneous Interventions, Oxfordshire, Taylor & Francis
  3. Aoki J, Lansky AJ, Mehran R, Moses J, Bertrand ME, McLaurin BT, Cox DA, Lincoff AM, Ohman EM, White HD, Parise H, Leon MB, Stone GW (2009). Early stent thrombosis in patients with acute coronary syndromes treated with drug-eluting and bare metal stents: the Acute Catheterization and Urgent Intervention Triage Strategy trial. Circulation 119, 687-698
  4. Bhatt SH and Hauser TH (2008). Very late stent thrombosis after dual antiplatelet therapy discontinuation in a patient with a history of acute stent thrombosis. Ann Pharmacother 42, 708-712
  5. Brener SJ, Cristea E, Kirtane AJ, McEntegart MB, Xu K, Mehran R, Stone GW (2013). Intra-procedural stent thrombosis: a new risk factor for adverse outcomes in patients undergoing percutaneous coronary intervention for acute coronary syndromes. JACC Cardiovasc Interv 6, 36–43
  6. Buchanan GL, Basavarajaiah S, Chieffo A (2012). Stent thrombosis: incidence, predictors and new technologies. Thrombosis 2012, 956962
  7. Cheng YC, Tsai CS, Lin YC, Kao CH, Tsai YT (2012). Multiple episodes of arterial thrombosis in a young man with protein C deficiency: a case report. Vascular 20, 318-320
  8. D'Amato R (no year). Myocardial infarction in the young. Available from http://spo.escardio.org/eslides/ view.aspx?eevtid=48&fp=1065. Accessed June 13, 2014
  9. Dangas GD, Caixeta A, Mehran R, Parise H, Lansky AJ, Cristea E, Brodie BR, Witzenbichler B, Guagliumi G, Peruga JZ, Dudek D, Möeckel M, Stone GW (2011). Frequency and predictors of stent thrombosis after percutaneous coronary intervention in acute myocardial infarction. Circulation 123, 1745-1756
  10. Elmariah S and Jang IK (2012). Acute stent thrombosis: technical complication or inadequate antithrombotic therapy? An optical coherence tomography study. JACC Cardiovasc Interv 5, e3– e4
  11. Genetics Home Reference (2013). Protein C deficiency. Available from https://ghr.nlm.nih.gov/condition/ protein-c-deficiency. Accessed May 20, 2014
  12. Hayashida M, Yamada H, Yamazaki S, Nomura H, Yoshimura K, Kitahara O, Momose K, Kubo K, Kurihara M, Hamasaki N (2003). Combined protein C and protein S deficiency in a family with repetitive thromboembolism and segregated gene mutations. Intern Med 42, 268-272
  13. Kattel S, Regmi S, Neopane A, Karki DB (2011). Combined protein C and protein S deficiency presenting as deep vein thrombosis. Journal of Coagulation Disorders 3, 71-73
  14. Kirtane AJ and Stone GW (2011). How to minimize stent thrombosis. Circulation 124, 1283-1287
  15. Kottke-Marchant K and Comp P (2002). Laboratory issues in diagnosing abnormalities of protein C, thrombomodulin, and endothelial cell protein C receptor. Arch Pathol Lab Med 126, 1337–1348
  16. Lipe B and Ornstein DL (2011). Deficiencies of natural anticoagulants, protein C, protein S, and antithrombin. Circulation 124, e365-e368
  17. Mohanty D, Ghosh K, Khare A, Kulkarni B (2004). Thrombophilia in coronary artery disease: a double jeopardy. Indian J Med Res 120, 13-23
  18. ten Kate MK and van der Meer J (2008). Protein S deficiency: a clinical perspective. Haemophilia 14, 1222–1228
  19. Tiong IY, Alkotob ML, Ghaffari S (2003). Protein C deficiency manifesting as an acute myocardial infarction and ischaemic stroke. Heart 89, E7
  20. Wenaweser P, Rey C, Eberli FR, Togni M, Tüller D, Locher S, Remondino A, Seiler C, Hess OM, Meier B, Windecker S (2005). Stent thrombosis following bare-metal stent implantation: success of emergency percutaneous coronary intervention and predictors of adverse outcome. European Heart Journal 26, 1180–1187