This case report describes recurrent drug-eluting stent thrombosis with documented laboratory hyporesponsiveness to clopidogrel. The use of escalating doses of clopidogrel prevented subsequent episodes, but the patient developed gastrointestinal intolerance and diffuse cutaneous reaction, which resolved completely with prasugrel. Impressively, prasugrel 10 mg daily achieved an even lower vasodilator-stimulated phosphoprotein platelet reactivity index compared to clopidogrel 300 mg daily. Our case highlights the importance of alternative P2Y12 receptor antagonists for patients receiving drug-eluting stents.
Angioplasty, Balloon, Coronary ; Drug-Eluting Stents ; adverse effects ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; therapy ; Piperazines ; therapeutic use ; Platelet Aggregation Inhibitors ; administration & dosage ; Prasugrel Hydrochloride ; Thiophenes ; therapeutic use ; Thrombosis ; drug therapy ; Ticlopidine ; administration & dosage ; analogs & derivatives ; Treatment Failure

Adipose tissue is a central metabolic organ that controls energy homeostasis of the whole body. White adipose tissue (WAT) stores excess energy in the form of triglycerides, whereas brown adipose tissue (BAT) dissipates energy in the form of heat through mitochondrial uncoupling protein 1 (Ucp1). A newly identified adipose tissue called ‘beige fat’ (BAT-like) is produced through a process called WAT browning. This tissue mainly resides in WAT depots and displays intermediate characteristics of both WAT and BAT. Since the recent discovery of BAT in the human body, along with the identification of molecular targets for BAT activation, stimulating energy expenditure has been considered as a great strategy to treat human obesity and metabolic diseases. Here we summarize recent findings regarding molecular targets and thermogenic small molecules that can stimulate BAT and increase energy expenditure, with an emphasis on possible therapeutic applications in humans.
Adipocytes* ; Adipose Tissue ; Adipose Tissue, Brown ; Adipose Tissue, White ; Energy Metabolism ; Homeostasis ; Hot Temperature ; Human Body ; Humans ; Metabolic Diseases ; Obesity ; Triglycerides