Sirolimus
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Very late coronary stent thrombosis in an elderly patient: case report A 72-year-old man developed very late coronary stent thrombosis after implantation of a sirolimus-eluting stent [Cypher; dosage not stated]. The man, who had hypertension and essential thrombocythaemia, presented with acute coronary syndrome accompanied by persistent ST elevation in the lower leads. Approximately 24 months (715 days) earlier, he had undergone a coronary angioplasty and implantation of a sirolimus-eluting stent. ECG revealed sinus tachycardia and an HR of 104bpm, and echocardiography showed a moderate reduction of the left ventricular ejection fraction with abnormalities of lower region local kinetics. He also had slightly increased troponin T levels and thrombocytosis. The man underwent emergency coronary angiography, which revealed thrombotic occlusion of the right coronary artery, and subcritical stenoses of the left anterior descending and circumflex arteries. Thromboaspiration and balloon catheterisation were performed, and eptifibatide was administered. He was subsequently discharged receiving clopidogrel and aspirin, and recommended for close follow-up [outcome not stated]. Author comment: Very late thrombosis seems to be prevalent in drug-eluting stents. Mele M, et al. [Very late coronary drug-eluting stent thrombosis in a patient with essential thrombocythemia: a case report of a rare association]. Giornale Italiano di Cardiologia 13: 520-2, No. 78, Jul 2012. Available from: URL: http:// dx.doi.org/10.1714/1114.12248 [Italian; summarised from a translation] 803081697 Italy
0114-9954/10/1434-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Reactions 12 Jan 2013 No. 1434
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