Published Paper Details:

Drug-eluting stents (DES) are considered the treatment of choice for most patients with obstructive coronary artery disease when percutaneous intervention (PCI) is feasible. However, Stent thrombosis (ST) is a rare complication but have around 15-45% case fatality rate. We report the cases of a young patient admitted for the management of a previous myocardial infarction related to subacute stent thrombosis. The incidence of stent thrombosis is poorly understood around the world. Several factors have been associated with ST, including patient specific factors (older age, black race and diabetes mellitus), procedure-related factors (stent underexpansion, incomplete apposition, greater stent length) and factors depending on the pharmacological therapy (non-compliance to anti-platelet agent and anti-platelet resistance). Anti-platelet resistance is an independent predictor of ST, even several years after implantation of DES and increases the risk of ST. Recent studies have shown that adequate anti-platelet effects are not achieved in 5% to 45% of the patients taking and in 4% to 30% of patients taking clopidogrel. Currently, however, routine screening for antiplatelet resistance remains a persistent, unresolved issue and further evidence is necessary before it will be possible to recommend this testing as part of standard assessment of PCI candidates. In addition, further prospective studies are needed to set guidelines for optimal treatment of patients with antiplatelet resistance who are at increased risk of ST, a catastrophic complication of DES implantation. In the DES era, stent thrombosis is a fatal complication and antiplatelet therapy has been shown to be very important in preventing stent thrombosis. Thus, assessment of the patient's responsiveness to antiplatelet agents may be a crucial factor in monitoring these drugs' therapeutic efficiency and improving clinical outcomes after implantation of DES.