Late stent thrombosis in a patient with CYP2C19*3/*17 genotype and clopidogrel high on-treatment platelet reactivity. (7th September 2018)

• Record Type: Journal Article
• Authors: Tan, Shirley Siang Ning; Koh, Keng Tat; Tiong, Lee Len; Ong, Tiong Kiam; Fong, Alan Yean Yip
• Is Part Of: Pharmacogenomics. Volume 19:Number 15(2018)
• Page Start: 1151
• Page End: 1157
• Publication Date: 2018-09-07
• Subjects: CYP2C19*3/*17 -- late stent thrombosis -- point-of-care genotyping; Pharmacogenomics -- Periodicals; 615.1
• DOI: 10.2217/pgs-2018-0082
• Languages: English
• ISSNs: 1462-2416

Abstract

Aim: Recurrent thrombotic events still occur despite dual antiplatelet therapy in patient's post percutaneous coronary intervention (PCI) could be attributed to high on-treatment platelet reactivity.Methods: A 44-year-old male, who had staged PCI to left anterior descending (LAD) 2 weeks after an anterior MI, with a drug-coated stent was readmitted with new anterior STEMI 35 days later. Coronary angiogram revealed mid-stent thrombus in situ . He had further uncomplicated PCI. Platelet function testing and genotyping showed clopidogrel high on-treatment platelet reactivity and CYP2C19*3/*17 genotype. Ticagrelor was commenced.Results & conclusion: This case study is the first reported in Malaysia to document a patient with a CYP2C19*3/*17 genotype presenting with a stent thrombosis after an uncomplicated index PCI procedure.