Despite aggressive antiplatelet therapy in the setting of PCI, the incidence of acute stent thrombosis remains approximately 0.5-2%. We report a patient with simultaneous thrombosis of two drug-eluting coronary artery stents, suggesting a systemic thrombotic state. Evaluation by optical platelet aggregometry revealed clopidogrel resistance, which was overcome at a higher drug dose. We aim to highlight the potential utility of platelet function analysis to guide therapy for patients in whom inadequate antiplatelet therapy may have catastrophic clinical outcomes.