Case Report

Netherlands Heart Journal

, Volume 20, Issue 1, pp 38-41

First online:

Early double stent thrombosis associated with clopidogrel hyporesponsivenesss

  • L. M. RademakersAffiliated withDepartment of Cardiology, Catharina Hospital Email author 
  • , W. DewildeAffiliated withDepartment of Cardiology, Catharina Hospital
  • , D. van de KerkhofAffiliated withDepartment of Clinical Chemistry, Catharina Hospital

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A 57-year-old male patient without cardiovascular history suffered an acute myocardial infarction and underwent drug-eluting stent implantation in the left anterior descending artery. A few days later, the right coronary artery was also stented (drug-eluting stent). Three days later, he was re-admitted to our hospital in cardiogenic shock. Emergent coronary angiography showed total occlusion of both stents. Platelet function analysis (PFA) showed attenuated platelet inhibition in response to clopidogrel treatment. The patient was the carrier of a loss-of-function polymorphism in the CYP2C19 gene, which has been associated with increased incidence of adverse thrombotic events. Antiplatelet therapy was switched to prasugrel and PFA revealed an adequate antiplatelet effect.


Thrombosis Stents Clopidogrel Prasugrel CYP2C19