Late stent thrombosis associated with heavy exercise
Texas Heart Institute Journal, cilt.36, sa.2, ss.154-157, 2009 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 36 Sayı: 2
- Basım Tarihi: 2009
- Dergi Adı: Texas Heart Institute Journal
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
- Sayfa Sayıları: ss.154-157
- Anahtar Kelimeler: Aspirin/administration & dosage/therapeutic use, blood vessel prosthesis implantation/adverse effects, coronary disease/therapy, coronary restenosis/etiology/pathology/prevention & control/therapy, coronary thrombosis/etiology/therapy, exercise/physiology, myocardial revascularization, platelet aggregation inhibitors/administration & dosage;, postoperative complications/etiology, stents/adverse effects, treatment outcome
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Bare-metal stents are commonly used in the treatment of coronary artery disease. Stent thrombosis usually occurs within the first 48 hours after stent deployment. After a week, the incidence of thrombosis is low. Late stent thrombosis (after 30 days) is rarely seen; however, its clinical outcomes are severe 30-day mortality rates of 20% to 48% and myocardial infarction rates of 60% to 70%. Herein, we present the case and discuss the treatment of a patient who, after heavy exercise, experienced acute myocardial infarction due to late thrombosis in a bare-metal stent. A 54-year-old man presented with unstable angina pectoris. Coronary angiography revealed critical occlusion of the middle right coronary artery. A bare-metal stent was implanted, and he was discharged from the hospital on a medical regimen. Eleven months later, he presented with acute myocardial infarction, which had developed after heavy exercise. Coronary angiography revealed occlusion of the stent in the right coronary artery. After the occlusion was crossed with a guidewire, balloon angioplasty was applied, and Thrombosis-in-Myocardial-Infarction (TIMI)-3 flow was restored. The patient was asymptomatic during his 5-day hospitalization and was discharged on dual antiplatelet therapy. In addition to presenting this patient's case, we discuss mechanisms that may contribute to late stent thrombosis, implications of the condition, and preventive therapy. © 2009 by the Texas Heart® Institute.