Stent thrombosis in a patient with acute coronary syndrome without ST segment elevation with high residual platelet reactivity
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Abstract
Stent thrombosis is a dangerous life-threatening condition, which is more frequent during the first month after stent implantation. Currently, there are several possible schemes for preventing stent thrombosis with clopidogrel and stronger P2Y12 receptor inhibitors. The article describes the clinical case of stent thrombosis in a patient with clopidogrel resistance against the background of carrying the allelic variant of the gene CYP2C19*2, a «slow metabolizer of clopidogrel». Despite the recommended use of high doses of clopidogrel to improve the clinical outcome in patients with a homozygote CYP2C19*2 (*2/*2), this clinical case showed high doubtfulness of such tactics. In such cases, the use of more potent inhibitors of P2Y12 receptors is justified, since it allows improving clinical outcomes of mechanical revascularization.
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