Keimyung Med J.  2016 Jun;35(1):18-24. 10.0000/kmj.2016.35.1.18.

An Intra-procedural Stent Thrombosis in a Prasugrel Resistant Patient Treated with Ticagrelor

Affiliations
  • 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.

Keyword

Prasugrel resistance; Stent thrombosis; Ticagrelor
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