Keimyung Medical Journal  2016;35(1):18-24

An Intra-procedural Stent Thrombosis in a Prasugrel Resistant Patient Treated with Ticagrelor.

Jung Ho PARK 1 ; Seung Ho HUR ; Yun Kyeong CHO ; Hyoung Seob PARK ; Hyuck Jun YOON ; Sang Hoon LEE ; Hyung Seop KIM ; Chang Wook NAM ; Seong Wook HAN

Affiliations

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Keywords

Prasugrel resistance; Stent thrombosis; Ticagrelor

Country

Republic of Korea

Language

English

Abstract

Stent thromboses due to multifactorial causes including hypercoagulable conditions and high on treatment platelet reactivity (HTPR), which means a low response to anti-platelet therapy, especially clopidogrel. Prasugrel is a third generation thienopyridine and inactive pro-drug requiring metabolic activation in vivo, which improves the rate of HTPR with clopidogrel. This drug is mostly effective, with a potent, fast, and consistent anti-platelet action, but rare cases of inadequate platelet inhibition with prasugrel have been reported. Here we describe the case of a 47-year-old man who presented with a recurrent acute myocardial infarction and ST during an intravascular ultrasound pullback and was resistant to prasugrel, was successfully treated with ticagrelor.