Resistance to platelet antiaggregants: an important cause of very late thrombosis of drug eluting stents? Observations from five cases

Autor: J. Machecourt, Bernard Bertrand, G. Barone-Rochette, O. Ormezzano, Gérald Vanzetto, B. Polack
Přispěvatelé: Clinique Cardiologie et Hypertension Artérielle, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-Hôpital Michallon, Radiopharmaceutiques Biocliniques, Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM), TheREx, Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)
Rok vydání: 2008
Předmět:
Male
MESH: Coronary Thrombosis
[SDV.BIO]Life Sciences [q-bio]/Biotechnology
Platelet Aggregation
medicine.medical_treatment
Drug Resistance
Thrombose très tardive
MESH: Flow Cytometry
030204 cardiovascular system & hematology
Résistanceau clopidogrel
Very late thrombosis
MESH: Aged
80 and over
0302 clinical medicine
MESH: Fibrinolytic Agents
Platelet
Prospective Studies
030212 general & internal medicine
Phosphorylation
[INFO.INFO-BT]Computer Science [cs]/Biotechnology
Prospective cohort study
Resistance to aspirin
MESH: Platelet Aggregation
Aged
80 and over
MESH: Aged
Aspirin
MESH: Middle Aged
Microfilament Proteins
Stent actif
Drug-Eluting Stents
MESH: Platelet Function Tests
General Medicine
Middle Aged
Flow Cytometry
Résistance à l’aspirine
Clopidogrel
Thrombosis
3. Good health
MESH: Platelet Aggregation Inhibitors
Drug-eluting stent
Anesthesia
MESH: Cell Adhesion Molecules
MESH: Drug Resistance
Cardiology
Female
Cardiology and Cardiovascular Medicine
MESH: Drug-Eluting Stents
medicine.drug
medicine.medical_specialty
Ticlopidine
Platelet Function Tests
MESH: Ticlopidine
Active stent
MESH: Phosphoproteins
MESH: Microfilament Proteins
03 medical and health sciences
Fibrinolytic Agents
Internal medicine
medicine
Humans
MESH: Aspirin
Aged
MESH: Humans
MESH: Phosphorylation
Vascular disease
business.industry
Coronary Thrombosis
Phosphoproteins
medicine.disease
MESH: Male
MESH: Prospective Studies
Resistance to clopidogrel
Complication
business
Cell Adhesion Molecules
MESH: Female
Platelet Aggregation Inhibitors
Zdroj: Archives of cardiovascular diseases
Archives of cardiovascular diseases, Elsevier/French Society of Cardiology, 2008, 101 (2), pp.100-7. ⟨10.1016/S1875-2136(08)70266-3⟩
ISSN: 1875-2136
DOI: 10.1016/s1875-2136(08)70266-3
Popis: International audience; BACKGROUND: Very late thrombosis of drug eluting stents is a rare complication that might be triggered by resistance to platelet antiaggregants (PAAs). AIM: Following an initial case where clinical data strongly suggested resistance to PAAs, we carried out a prospective systematic analysis of platelet aggregation in four subsequent cases of late thrombosis. METHODS: Resistance to aspirin was investigated with the PFA-100 test employing a collagen-epinephrine cartridge (Platelet Function Analyzer; Dade Behring). Resistance to clopidogrel was determined by flow cytometry of intraplatelet vasodilator-stimulated phosphoprotein (VASP) phosphorylation. RESULTS: All four cases showed resistance to either aspirin or clopidogrel, and two cases showed dual resistance to both of these PAAs. CONCLUSION: Analysis of platelet function in a patient with late stent thrombosis is useful and may allow adaptation of subsequent patient management. The value of monitoring platelet function after implantation of a drug eluting stent should be evaluated in prospective studies.
Databáze: OpenAIRE
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