Simultaneous left anterior descending and right coronary stent thrombosis after aspirin withdrawal.

Abstract

ST-segment elevation myocardial infarction is usually caused by plaque rupture and subsequent thrombosis of a single culprit vessel. In rare occasions, simultaneous thrombosis of 2 coronary arteries occurs, which is usually associated with a worse prognosis. Although surgery provokes hemodynamic stress, leading in some instances to myocardial ischemia due to supply/demand mismatch, other factors may also contribute to postoperative myocardial infarction. We present a case of postoperative simultaneous left anterior descending and right coronary stent thrombosis that followed cessation of long-term aspirin therapy in a patient with stable coronary artery disease. This case raises concerns with drug-eluting stents due to the higher potential for late stent thrombosis related to delayed endothelialization of the stent struts. Physicians should be very cautious when deciding to withdraw antiplatelet therapy preoperatively to avoid rebound coronary thrombosis.

• Authors: Hesham R Omar, Devanand Mangar, Rachel Karlnoski, Hany D Abdelmalak, Enrico M Camporesi
• Journal: The American journal of emergency medicine (Am J Emerg Med) Vol. 30 Issue 9 Pg. 2093.e5-8 (Nov 2012) ISSN: 1532-8171 [Electronic] United States
• PMID: 22386339 (Publication Type: Case Reports, Journal Article)

Chemical References

• Platelet Aggregation Inhibitors
• Aspirin

Topics

• Aged
• Aspirin (therapeutic use)
• Coronary Artery Disease (surgery)
• Coronary Restenosis (complications, etiology)
• Coronary Thrombosis (complications, etiology)
• Drug-Eluting Stents (adverse effects)
• Electrocardiography
• Fatal Outcome
• Humans
• Male
• Myocardial Infarction (etiology)
• Platelet Aggregation Inhibitors (therapeutic use)
• Ventricular Fibrillation (etiology)