Korean Circulation Journal

The Korean Society of Cardiology (대한심장학회)
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Recurrent Stent Thrombosis in a Patient with Antiphospholipid Syndrome and Dual Anti-Platelet Therapy Non-Responsiveness

  • Lee, You-Hong (Department of Cardiology, Ajou University School of Medicine) ;
  • Yang, Hyoung-Mo (Department of Cardiology, Ajou University School of Medicine) ;
  • Tahk, Seung-Jea (Department of Cardiology, Ajou University School of Medicine) ;
  • Hong, You-Sun (Department of Thoracic and Cadiovascular Surgery, Ajou University School of Medicine) ;
  • Park, Jin-Sun (Department of Cardiology, Ajou University School of Medicine) ;
  • Seo, Kyoung-Woo (Department of Cardiology, Ajou University School of Medicine) ;
  • Choi, Yong-Woo (Department of Cardiology, Ajou University School of Medicine) ;
  • Noh, Choong-Kyun (Department of Cardiology, Ajou University School of Medicine)
  • Received : 2014.01.10
  • Accepted : 2014.06.09
  • Published : 2015.01.30
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Abstract

Antiphospholipid syndrome (APS), the most common acquired hypercoagulable condition, is diagnosed by persistent presence of antiphospholipid antibodies and episodes of vascular thrombosis. It may be an important predisposing factor for stent thrombosis, resulting in poor outcomes. Also, anti-platelet therapy non-responsiveness is associated with stent thrombosis. We report a case of a 39-year-old man who after undergoing successful percutaneous coronary intervention for significant coronary artery disease suffered repeated stent thrombosis events leading to ST-segment elevation myocardial infarction. Eventually, he underwent coronary artery bypass surgery because of uncontrolled thrombosis and was diagnosed as having APS and dual antiplatelet therapy non-responsiveness.

Keywords

References

  1. Wilson WA, Gharavi AE, Koike T, et al. International consensus statement on preliminary classification criteria for definite antiphospholipid syndrome: report of an international workshop. Arthritis Rheum 1999;42:1309-11. https://doi.org/10.1002/1529-0131(199907)42:7<1309::AID-ANR1>3.0.CO;2-F
  2. Takeuchi S, Obayashi T, Toyama J. Primary antiphospholipid syndrome with acute myocardial infarction recanalised by PTCA. Heart 1998;79:96-8. https://doi.org/10.1136/hrt.79.1.96
  3. Ludia C, Domenico P, Monia C, et al. Antiphospholipid antibodies: a new risk factor for restenosis after percutaneous transluminal coronary angioplasty? Autoimmunity 1998;27:141-8. https://doi.org/10.3109/08916939809003861
  4. van Werkum JW, Heestermans AA, Zomer AC, et al. Predictors of coronary stent thrombosis: the Dutch Stent Thrombosis Registry. J Am Coll Cardiol 2009;53:1399-409. https://doi.org/10.1016/j.jacc.2008.12.055
  5. Miyakis S, Lockshin MD, Atsumi T, et al. International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). J Thromb Haemost 2006;4:295-306. https://doi.org/10.1111/j.1538-7836.2006.01753.x
  6. Kimura T, Morimoto T, Nakagawa Y, et al. Antiplatelet therapy and stent thrombosis after sirolimus-eluting stent implantation. Circulation 2009;119:987-95. https://doi.org/10.1161/CIRCULATIONAHA.108.808311
  7. Burzotta F, Parma A, Pristipino C, et al. Angiographic and clinical outcome of invasively managed patients with thrombosed coronary bare metal or drug-eluting stents: the OPTIMIST study. Eur Heart J 2008;29:3011-21. https://doi.org/10.1093/eurheartj/ehn479
  8. Tripodi A, Chantarangkul V, Clerici M, Negri B, Galli M, Mannucci PM. Laboratory control of oral anticoagulant treatment by the INR system in patients with the antiphospholipid syndrome and lupus anticoagulant. Results of a collaborative study involving nine commercial thromboplastins. Br J Haematol 2001;115:672-8. https://doi.org/10.1046/j.1365-2141.2001.03178.x
  9. Cervera R, Piette JC, Font J, et al. Antiphospholipid syndrome: clinical and immunologic manifestations and patterns of disease expression in a cohort of 1,000 patients. Arthritis Rheum 2002;46:1019-27. https://doi.org/10.1002/art.10187
  10. Perl L, Netzer A, Rechavia E, et al. Long-term outcome of patients with antiphospholipid syndrome who undergo percutaneous coronary intervention. Cardiology 2012;122:76-82. https://doi.org/10.1159/000338347
  11. Muir DF, Stevens A, Napier-Hemy RO, Fath-Ordoubadi F, Curzen N. Recurrent stent thrombosis associated with lupus anticoagulant due to renal cell carcinoma. Int J Cardiovasc Intervent 2003;5:44-6. https://doi.org/10.1080/14628840304613
  12. Weissman A, Coplan NL. Antiphospholipid antibody syndrome and acute stent thrombosis. Rev Cardiovasc Med 2006;7:244-6.
  13. Middlebrooks EH, Panda M. Multiple recurrent stent thrombosis in a patient with coexisting clopidogrel resistance and increased anticardiolipin antibodies: a case report. Case Rep Med 2010;2010:974149.
  14. Musuraca G, Imperadore F, Terraneo C, et al. Successful treatment of post-exertion acute myocardial infarction by primary angioplasty and stenting in a patient with antiphospholipid antibody syndrome. Blood Coagul Fibrinolysis 2004;15:95-8. https://doi.org/10.1097/00001721-200401000-00015
  15. Lockshin M, Tenedios F, Petri M, et al. Cardiac disease in the antiphospholipid syndrome: recommendations for treatment. Committee consensus report. Lupus 2003;12:518-23. https://doi.org/10.1191/0961203303lu391oa
  16. Levine SR, Brey RL, Tilley BC, et al. Antiphospholipid antibodies and subsequent thrombo-occlusive events in patients with ischemic stroke. JAMA 2004;291:576-84. https://doi.org/10.1001/jama.291.5.576
  17. Lim W, Crowther MA, Eikelboom JW. Management of antiphospholipid antibody syndrome: a systematic review. JAMA 2006;295:1050-7. https://doi.org/10.1001/jama.295.9.1050
  18. Klomp M, Beijk MA, Varma C, et al. 1-year outcome of TRIAS HR (TRIstent adjudication study-high risk of restenosis) a multicenter, randomized trial comparing genous endothelial progenitor cell capturing stents with drug-eluting stents. JACC Cardiovasc Interv 2011;4:896-904. https://doi.org/10.1016/j.jcin.2011.05.011

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