Late Coronary Stent Thrombosis in a Patient With COVID-19: A
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A case of late stent thrombosis in a patient hospitalized with COVID-19 called attention to the importance of antithrombotic therapy for those with coronary artery disease (CAD) who get infected, according to a case report from Spain.

An 81-year-old man presented in April 2020 with an anterior ST-segment elevation MI. Urgent coronary angiography revealed thrombotic occlusion of a durable-polymer ridaforolimus drug-eluting stent (DES) in the proximal left anterior descending (LAD) coronary artery.

This stent had been placed in a de novo lesion 3 months prior. It overlapped an older DES, coming from the left main, implanted 5 years prior.

Optical coherence tomography revealed stent underexpansion, uncovered struts, and malapposition that may have predisposed the patient to stent thrombosis. Then COVID-19's hallmark "intense inflammatory and prothrombotic milieu" could have triggered the late stent thrombosis, researchers suggested.

"However, these findings suggest that special care should be paid to optimize antithrombotic therapy in patients with COVID-19 with previous CAD," they concluded.

Source: https://jamanetwork.com/journals/jamacardiology/fullarticle/2768162
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