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Coronary thrombosis: In vivo, ex vivo and in vitro. | LitMetric

Coronary thrombosis: In vivo, ex vivo and in vitro.

BMJ Case Rep

East & North Hertfordshire NHS Trust, Cardiology, Queen Elizabeth II Hospital, Welwyn Garden City AL7 4HQ, UK.

Published: November 2011

AI Article Synopsis

  • - Acute stent thrombosis is a critical issue in cardiology, linked to a prothrombotic state that isn't fully understood.
  • - A case is presented where a patient experienced stent thrombosis just an hour after rescue angioplasty, despite receiving full doses of fibrinolytics and antiplatelet drugs.
  • - A novel near-patient test was effectively used to predict the risk of stent thrombosis and showed changes in the patient's thrombotic state after abciximab treatment, marking a significant advancement in the procedure.

Article Abstract

Acute stent thrombosis remains one of the most important concerns in clinical cardiology. The mechanism is not fully understood but a prothrombotic state is a key component. We describe a case of acute stent thrombosis, within an hour of rescue angioplasty, despite use of full dose fibrinolytic (reteplase) and antiplatelet therapy (aspirin and clopidogrel). Risk of acute stent thrombosis was predicted an hour earlier, when the patient was clinically well, by a novel near-patient test of thrombotic and thrombolytic status (in vitro). Subsequent stent thrombosis was visualised angiographically (in vivo) and confirmed by extraction of the thrombus (ex vivo). The near-patient test sensitively detected reversal of the prothrombotic state after abciximab treatment. We believe this is the first description of the clinical use of a near-patient test within the cardiac catheterisation laboratory to predict risk of imminent stent thrombosis.

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3027665PMC
http://dx.doi.org/10.1136/bcr.09.2008.0983DOI Listing

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