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Keimyung Medical Journal 2016;35(1):18-24.
Published online June 22, 2016.
An Intra-procedural Stent Thrombosis in a Prasugrel Resistant Patient Treated with Ticagrelor.
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.
Abstract
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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