Diabetes mellitus: a prothrombotic state implications for outcomes after coronary revascularization

Vasc Health Risk Manag. 2009;5(1):101-19. doi: 10.2147/vhrm.s4248. Epub 2009 Apr 8.

Abstract

Coronary stent thrombosis is a serious problem in the drug-eluting stent era. Despite aggressive antiplatelet therapy during and after percutaneous coronary intervention (PCI), the incidence of sub-acute stent thrombosis remains approximately 0.5%-2%, which may represent a catastrophic clinical situation. Both procedural factors and discontinuation of antiplatelet therapy are normally associated with this event. We report on simultaneous stent thromboses of two drug-eluting stents implanted in two different vessels, which resulted in a life-threatening clinical condition. Possible contributing factors that led to synergistic thrombotic effects are discussed.

Keywords: antiplatelet therapy; diabetes mellitus; drug-eluting stent; platelet function; stent thrombosis.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Angioplasty, Balloon, Coronary / adverse effects*
  • Angioplasty, Balloon, Coronary / instrumentation
  • Aspirin / therapeutic use
  • Cardiovascular Agents / administration & dosage
  • Clopidogrel
  • Coronary Angiography
  • Coronary Stenosis / diagnostic imaging
  • Coronary Stenosis / etiology
  • Coronary Stenosis / therapy*
  • Coronary Thrombosis / diagnostic imaging
  • Coronary Thrombosis / etiology*
  • Coronary Thrombosis / therapy
  • Diabetes Mellitus, Type 2 / complications*
  • Drug-Eluting Stents
  • Female
  • Humans
  • Medication Adherence
  • Middle Aged
  • Myocardial Infarction / diagnostic imaging
  • Myocardial Infarction / etiology
  • Myocardial Infarction / therapy*
  • Platelet Aggregation Inhibitors / therapeutic use
  • Risk Factors
  • Sirolimus / administration & dosage
  • Ticlopidine / analogs & derivatives
  • Ticlopidine / therapeutic use
  • Treatment Outcome

Substances

  • Cardiovascular Agents
  • Platelet Aggregation Inhibitors
  • Clopidogrel
  • Ticlopidine
  • Aspirin
  • Sirolimus