Case report

Clopidogrel resistance "Live" – the risk of stent thrombosis should be evaluated before procedures

Zuzana Motovska¹ , Petr Widimsky¹ , Iuri Marinov² , Robert Petr¹ , Jaroslava Hajkova³ and Jan Kvasnicka³ for the PRAGUE-8 study Investigators

¹  Third Medical Faculty Charles University & University Hospital Kralovske Vinohrady, Prague, Czech Republic

²  The Institute of Hematology and Blood Transfusion, Prague, Czech Republic

³  First Medical Faculty Charles University and Thrombotic Centre General University Hospital, Prague, Czech Republic

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Thrombosis Journal 2009, 7:6doi:10.1186/1477-9560-7-6

Published:	19 May 2009

Abstract

Every year, millions of people undergo percutaneous coronary intervention (PCI) with intracoronary stent implantation. A patient from the PRAGUE-8 trial (Optimal pre-PCI clopidogrel loading: 600 mg before every coronary angiography vs. 600 mg in the cath-lab only for PCI patients) is described who suffered from acute stent thrombosis. This patient did not have any relevant inhibition of platelet activation even after the 600 mg dose of clopidogrel. Dose uptitration would have been ineffective. New P2Y₁₂ receptor inhibitors are desperately needed. In the light of recently published data, the use of prasugrel may be considered as an alternative.