Study highlights the role of genetic testing in evaluation of in-stent thrombosis

In a new publication from Cardiovascular Innovations and Applications, Nathan Burke, Tawanna Charlton, Hussam Hawamdeh, and Ki Park from the University of Florida College of Medicine, Gainesville, Florida, USA consider a case study of in-stent thrombosis after antiplatelet therapy conversion while awaiting coronary bypass.

In-stent thrombosis (IST) is a rare yet dangerous complication that may occur despite optimized coronary intervention in the cardiac catheterization laboratory.

The authors report a case of an 81-year-old man who presented with ST-elevation myocardial infarction. Right coronary artery (RCA) occlusion was suspected. RCA angiography and percutaneous coronary intervention were performed.

Complicated left coronary artery disease was subsequently discovered. Per cardiothoracic surgeon request, the patient was transitioned from ticagrelor to clopidogrel therapy in preparation for coronary artery bypass grafting. The patient experienced IST the day before surgery while receiving clopidogrel.

The authors review this case, which highlights the complexity of antiplatelet therapy choice and the role of genetic testing in evaluation of IST risk.