Document Detail


Acute stent thrombosis in a patient with giant cell arteritis.
MedLine Citation:
PMID:  18401478     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A 70-year-old man presented with a non-ST elevation myocardial infarction attributable to a 99% occlusion of his mid-left anterior descending artery and concomitant symptoms suggestive of giant cell arteritis. He underwent bare metal stenting, with an excellent angiographic result, and was placed on dual antiplatelet therapy, as well as oral prednisone 30 mg twice daily, while awaiting confirmatory temporal artery biopsy. Unfortunately, 70 h after percutaneous coronary intervention, he developed acute stent thrombosis. Platelet aggregometry demonstrated that he was responsive to acetylsalicylic acid, but marginally responsive to clopidogrel. Over the next 30 days, he had a marked clinical improvement, with an improvement in platelet response to clopidogrel that paralleled the clinical resolution of his vasculitis. The present case reports the first incidence of acute stent thrombosis associated with giant cell arteritis, and suggests that the proinflammatory milieu of acute inflammatory arthritides may warrant prolonged, aggressive antiplatelet therapy in the setting of an acute coronary syndrome.
Authors:
Jason Andrade; Abdullah Al Ali; Jacqueline Saw; Graham C Wong
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The Canadian journal of cardiology     Volume:  24     ISSN:  1916-7075     ISO Abbreviation:  Can J Cardiol     Publication Date:  2008 Apr 
Date Detail:
Created Date:  2008-04-10     Completed Date:  2008-05-05     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  8510280     Medline TA:  Can J Cardiol     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  e25-6     Citation Subset:  IM    
Affiliation:
Division of Cardiology, University of British Columbia, Vancouver General Hospital, Vancouver.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Transluminal, Percutaneous Coronary*
Aspirin / therapeutic use
Coronary Angiography
Coronary Artery Disease / diagnosis*,  drug therapy
Coronary Thrombosis / diagnosis*,  drug therapy
Giant Cell Arteritis / diagnosis*,  drug therapy
Humans
Male
Myocardial Infarction / therapy*
Platelet Aggregation Inhibitors / therapeutic use
Prednisone / therapeutic use
Stents*
Ticlopidine / analogs & derivatives,  therapeutic use
Chemical
Reg. No./Substance:
0/Platelet Aggregation Inhibitors; 50-78-2/Aspirin; 53-03-2/Prednisone; 55142-85-3/Ticlopidine; 90055-48-4/clopidogrel
Comments/Corrections

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