Clinical relevance of clopidogrel unresponsiveness during elective coronary stenting: experience with the point-of-care platelet function assay-100 C/ADP.

Background: Early identification of nonresponders to clopidogrel may be important in identifying subgroups of patients that might be at risk for future thrombotic events.

Methods: We prospectively assessed postclopidogrel platelet reactivity in 250 consecutive patients scheduled for elective percutaneous coronary intervention (PCI). All patients received dual antiplatelet therapy with 160 mg aspirin and a 300 mg loading dose of clopidogrel >12 hours before PCI.

Long (> or = 25 mm) stents for long coronary artery lesions. A safe conduct or a bridge too far for the interventional cardiologist?

Objective: Increased restenosis rates have been reported after stenting long lesions with multiple standard length stents. Long slotted tube stents have become available for the treatment of long lesions or dissections. To compare clinical outcome after the use of long Multi-Link stents in long coronary lesions versus standard length Multi-Link stents in Benestent type lesions.

Cardiac conduction disturbances in Lyme disease.

A young patient is described presenting with third-degree atrioventricular block, who had a flu-like syndrome a few weeks before admission. The diagnosis of Lyme disease was suspected by serologic antibody detection and confirmed by Western immunoblot assay. Pacing was necessary because an unstable escape rhythm persisted.