Abstract
Little is known about the antiplatelet action of the thienopyridines, clopidogrel and prasugrel, as well as the non-thienopyridine, ticagrelor, in patients suffering from ST-elevation myocardial infarction (STEMI) complicated by cardiogenic shock since systematic comparisons of these antiplatelet agents in this devastating condition are limited so far. This is a report of a patient with STEMI undergoing urgent PCI in cardiogenic shock followed by repeated angioplasty after suffering early stent thrombosis (ST) who showed dual thienopyridine treatment failure of clopidogrel and prasugrel, which was successfully overcome by switching the patient to the non-thienopyridine derivative ticagrelor.
MeSH terms
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Adenosine / adverse effects
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Adenosine / analogs & derivatives*
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Adenosine / therapeutic use
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Aged
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Cardiopulmonary Resuscitation
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Clopidogrel
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Humans
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Myocardial Infarction / blood
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Myocardial Infarction / drug therapy*
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Myocardial Infarction / therapy
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Piperazines / adverse effects
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Piperazines / therapeutic use*
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Platelet Aggregation Inhibitors / adverse effects
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Platelet Aggregation Inhibitors / therapeutic use*
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Prasugrel Hydrochloride
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Purinergic P2Y Receptor Antagonists / adverse effects
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Purinergic P2Y Receptor Antagonists / therapeutic use*
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Shock, Cardiogenic / blood
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Shock, Cardiogenic / drug therapy*
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Shock, Cardiogenic / etiology
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Stents / adverse effects
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Thiophenes / adverse effects
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Thiophenes / therapeutic use*
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Thrombosis / blood
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Thrombosis / drug therapy*
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Thrombosis / etiology
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Ticagrelor
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Ticlopidine / adverse effects
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Ticlopidine / analogs & derivatives*
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Ticlopidine / therapeutic use
Substances
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Piperazines
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Platelet Aggregation Inhibitors
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Purinergic P2Y Receptor Antagonists
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Thiophenes
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Clopidogrel
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Prasugrel Hydrochloride
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Ticagrelor
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Adenosine
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Ticlopidine