A case of takotsubo cardiomyopathy associated with Kounis syndrome |
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Authors: | Yanagawa Youichi Nishi Kouichirou Tomiharu Niida Kawaguchi Takeo |
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Affiliation: | 1. Department of Traumatology and Critical Care Medicine, National Defense Medical College (NDMC), 3-2 Namiki Tokorozawa Saitama, 359-8513 Japan;2. Department of First Division of Internal Medicine, NDMC, Japan;3. Department of Cardiology, Odawara Municipal Hospital, Japan |
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Abstract: | In-stent restenosis (ISR) occurs in 20% to 40% of de novo coronary lesions treated with bare-metal stents (BMS), depending on lesion and patient-related factors. Drug-eluting stents coated with antiproliferative agents, represent a valid rationale for treatment and prevention of recurrent ISR, with low MACE rates. However, case reports and observational studies reported a definite increase in the incidence of late stent thrombosis after drug-eluting stents use, particularly in off-label cases and after clopidogrel withdrawal. The case we present shows target vessel occlusion occurring at the site of a previously implanted BMS, suggesting that in-stent restenosis was the main pathological mechanism leading to abrupt thrombotic vessel closure and acute myocardial infarction. |
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