Case Study A 63-year-old male was admitted with sub acute anterior ST-elevation myocardial infarction. Cardiac catheterisation revealed a subtotal occlusion in the proximal and middle part of left anterior descending coronary artery. Subacute stent thrombosis occurred recurrently until the last stent deployment solved the problem of the uncovered artery and distal-stent edge dissection. The patient's SYNTAX score was 19, and percutaneous coronary intervention (PCI) was performed. Unfortunately, sub acute stent thrombosis (SAT) occurred recurrently after drug eluting stent implantation. What reason should be responsible for the recurrent SAT, clopidogrel hypo response or mechanical factors? All anti-platelet therapy has been tried, but ADP-induced platelet aggregation remained hypo responsive to clopidogrel. The patient has shown symptom-free at follow-ups since the fourth PCI solved the problem of the uncovered artery and distal-stent edge dissection.
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