Stent thrombosis associated with newer P2Y12 inhibitors (ticagrelor & pasugrel) in a STEMI patient

Abstract

A 54-year-old Kuwaiti male presented an inferior wall ST elevation myocardial infarction (STEMI). Clopidogrel 600mg was administered by the first medical contact and Ticagrelor 180 mg with intravenous (IV) glycoprotein IIb/IIIa (GP IIb/IIIa) inhibitor infusion for 24 hours after primary percutaneous intervention. Despite this, several episodes of stent thrombosis occurred during the subsequent days. Because of this, Ticagrelor was switched to Pasugrel and the patient was loaded with 60mg of Pasugrel. Unfortunately, further in-stent thrombosis occurred and therefore, after discussion, coronary artery bypass graft surgery was performed.

Keywords

• Stent thrombosis
• Ticagrelor
• Pasugrel
• Tirofiban
• Heart team