Vascular Health and Risk Management (Jan 2009)
Diabetes mellitus: a prothrombotic state. Implications for outcomes after coronary revascularization
Abstract
Clarissa Cola1, Salvatore Brugaletta1, Victoria Martín Yuste1, Bieito Campos1, Dominick J Angiolillo2, Manel Sabaté11Interventional Cardiology Unit, Department of Cardiology, Sant Pau University Hospital, Barcelona, Spain; 2Interventional Cardiology Unit, Shands Jacksonville, University of Florida, Florida, USAAbstract: Coronary stent thrombosis is a serious problem in the drug-eluting stent era. Despite aggressive antiplatelet therapy during and after percutaneous coronary intervention (PCI), the incidence of sub-acute stent thrombosis remains approximately 0.5%–2%, which may represent a catastrophic clinical situation. Both procedural factors and discontinuation of antiplatelet therapy are normally associated with this event. We report on simultaneous stent thromboses of two drug-eluting stents implanted in two different vessels, which resulted in a life-threatening clinical condition. Possible contributing factors that led to synergistic thrombotic effects are discussed.Keywords: diabetes mellitus, platelet function, antiplatelet therapy, drug-eluting stent, stent thrombosis