Clopidogrel is an oral agent that blocks ADP receptor-mediated platelet aggregation. Clopidogrel along with aspirin was shown by the CURE trial to result in a 20% relative reduction of cardiovascular death, myocardial infarction or stroke. Ticlopidine has been shown to reduce the incidence of stent thrombosis compared with warfarin, but it may cause serious hematological side effects. However, the reported neutropenia has been similar to clopidogrel and aspirin treatment groups (0.01 vs 0.17%, respectively) with corresponding rates (0.05 vs 0.04%, respectively) of severe neutropenia. We treated a 72-year-old female patient with severe neutropenia who underwent percutaneous coronary intervention with drug-eluting stent placement and had no neutrophils in the peripheral blood at 11 days after clopidogrel use. Therefore, clinicians should be alerted to the possibility of severe neutropenia with clopidogrel treatment.
Adenosine Diphosphate ; Aged ; Aspirin ; Drug-Eluting Stents ; Female ; Humans ; Incidence ; Myocardial Infarction ; Neutropenia* ; Neutrophils ; Percutaneous Coronary Intervention ; Platelet Aggregation ; Stents ; Stroke ; Thrombosis ; Ticlopidine ; Warfarin