Candemir Başar, Güleç Sadi, Ozdemir Aydan Ongun, Kumbasar Deniz
Department of Cardiology, Ankara University.
Turk Kardiyol Dern Ars. 2010 Dec;38(8):561-3.
Duration of dual antiplatelet therapy after drug-eluting stent implantation is still an important issue awaiting a definite answer. A 50-year-old male patient was admitted with acute-onset chest pain and was diagnosed to have acute anterior myocardial infarction due to very late stent thrombosis. He had a 38-month history of two sirolimus-eluting stent implantation in the proximal left anterior descending (LAD) coronary artery. He had been on warfarin along with clopidogrel 75 mg/day until he decided to cease clopidogrel before a minor dental procedure 10 days before. Findings of physical examination and laboratory tests were normal except for an INR value of 4.4. After a loading dose of 300 mg clopidogrel, he was immediately taken to the catheterization laboratory. Angiography of the left system showed total occlusion of the proximal LAD with a thrombus at the level of the proximal stent. He was successfully revascularized without any complication and was discharged free of symptoms.
药物洗脱支架植入术后双联抗血小板治疗的持续时间仍是一个亟待明确答案的重要问题。一名50岁男性患者因急性胸痛入院，诊断为急性前壁心肌梗死，原因是极晚期支架血栓形成。他有在左冠状动脉前降支（LAD）近端植入两枚西罗莫司洗脱支架38个月的病史。他一直在服用华法林及每天75毫克氯吡格雷，直到10天前在一次小型牙科手术前决定停用氯吡格雷。体格检查和实验室检查结果均正常，国际标准化比值（INR）值为4.4除外。给予300毫克氯吡格雷负荷剂量后，他立即被送往导管室。左冠状动脉系统造影显示LAD近端完全闭塞，近端支架水平有血栓。他成功实现血管再通，无任何并发症，出院时无症状。
