| An Intra-procedural Stent Thrombosis in a Prasugrel Resistant Patient Treated with Ticagrelor. |
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Jung Ho Park, Seung Ho Hur, Yun Kyeong Cho, Hyoung Seob Park, Hyuck Jun Yoon, Sang Hoon Lee, Hyung Seop Kim, Chang Wook Nam, Seong Wook Han |
1Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea. shhur@dsmc.or.kr
2Department of Internal Medicine, Pohang St. Mary's Hospital1, Pohang, Korea. |
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| Abstract |
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Stent thromboses due to multifactorial causes including hypercoagulable conditions and high on treatment platelet reactivity (HTPR), which means a low response to anti-platelet therapy, especially clopidogrel. Prasugrel is a third generation thienopyridine and inactive pro-drug requiring metabolic activation in vivo, which improves the rate of HTPR with clopidogrel. This drug is mostly effective, with a potent, fast, and consistent anti-platelet action, but rare cases of inadequate platelet inhibition with prasugrel have been reported. Here we describe the case of a 47-year-old man who presented with a recurrent acute myocardial infarction and ST during an intravascular ultrasound pullback and was resistant to prasugrel, was successfully treated with ticagrelor. |
| Key Words:
Prasugrel resistance, Stent thrombosis, Ticagrelor |
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