{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T03:15:23Z","timestamp":1777950923854,"version":"3.51.4"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2023,11,14]],"date-time":"2023-11-14T00:00:00Z","timestamp":1699920000000},"content-version":"vor","delay-in-days":13,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,11,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Stent thrombosis is a potentially lethal complication of coronary angioplasty and responsible for 20% of all post-angioplasty myocardial infarctions. Unusual causes may be overlooked and difficult to identify.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>A 70-year-old male with history of triple aortocoronary bypass presented with acute inferolateral ST-segment elevation myocardial infarction (STEMI). Critical stenosis of the vein graft to the right coronary artery was revealed, and with the use of distal embolic protection device, successful angioplasty with stent was performed under double antiplatelet treatment with aspirin and ticagrelor. Two weeks later, he presented again at the emergency department with an acute inferolateral STEMI. Subacute stent thrombosis with complete occlusion of the stented vein graft was evident. Repeated balloon dilatations restored the flow stabilizing the patient; optical coherence tomography showed good stent expansion and apposition. Scrutinizing the patient\u2019s history, we discovered comedication with carbamazepine that is a CYP3A4 inducer and reduces ticagrelor\u2019s effect. Switching to prasugrel ensured potent antiplatelet treatment, and the patient was discharged 5 days later. The 6-month follow-up was uneventful and free of symptoms.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Stent thrombosis has dire consequences, and the precipitating factors should always be investigated. Inadequate platelet inhibition secondary to non-compliance to therapy or resistance and suboptimal stent expansion\/apposition are its main causes. Drug interactions are an underrecognized factor that may significantly alter the potency of antiplatelet drugs and also lead to stent thrombosis; thus, treatment is essential to be tailored to each patient comedication.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytad565","type":"journal-article","created":{"date-parts":[[2023,11,14]],"date-time":"2023-11-14T18:47:50Z","timestamp":1699987670000},"source":"Crossref","is-referenced-by-count":2,"title":["Subacute saphenous vein graft stent thrombosis due to unusual drug interaction: a case report"],"prefix":"10.1093","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7966-9174","authenticated-orcid":false,"given":"Leonidas","family":"Koliastasis","sequence":"first","affiliation":[{"name":"Department of Cardiology, Universit\u00e9 Libre de Bruxelles (ULB), Centre Hospitalier Universitaire Saint-Pierre , Rue Botanique 6 , 1210 Brussels, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Quentin","family":"de Hemptinne","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Universit\u00e9 Libre de Bruxelles (ULB), Centre Hospitalier Universitaire Saint-Pierre , Rue Botanique 6 , 1210 Brussels, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon","family":"Severin","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Universit\u00e9 Libre de Bruxelles (ULB), Centre Hospitalier Universitaire Saint-Pierre , Rue Botanique 6 , 1210 Brussels, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachid","family":"Briki","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Universit\u00e9 Libre de Bruxelles (ULB), Centre Hospitalier Universitaire Saint-Pierre , Rue Botanique 6 , 1210 Brussels, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8741-1720","authenticated-orcid":false,"given":"Panagiotis","family":"Xaplanteris","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Universit\u00e9 Libre de Bruxelles (ULB), Centre Hospitalier Universitaire Saint-Pierre , Rue Botanique 6 , 1210 Brussels, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2023,11,14]]},"reference":[{"key":"2023112515083530900_ytad565-B1","doi-asserted-by":"crossref","first-page":"2635","DOI":"10.1161\/CIRCULATIONAHA.117.029289","article-title":"Standardized end point definitions for coronary intervention trials: the Academic Research Consortium-2 consensus document","volume":"137","author":"Garcia-Garcia","year":"2018","journal-title":"Circulation"},{"key":"2023112515083530900_ytad565-B2","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1038\/s41569-018-0118-5","article-title":"Predictors of stent thrombosis and their implications for clinical practice","volume":"16","author":"Gori","year":"2019","journal-title":"Nat Rev Cardiol"},{"key":"2023112515083530900_ytad565-B3","doi-asserted-by":"crossref","first-page":"1007","DOI":"10.1161\/CIRCULATIONAHA.117.026788","article-title":"Optical coherence tomography findings in patients with coronary stent thrombosis: a report of the PRESTIGE Consortium (Prevention of Late Stent Thrombosis by an Interdisciplinary Global European Effort)","volume":"136","author":"Adriaenssens","year":"2017","journal-title":"Circulation"},{"key":"2023112515083530900_ytad565-B4","doi-asserted-by":"crossref","first-page":"1283","DOI":"10.1161\/CIRCULATIONAHA.110.976829","article-title":"How to minimize stent thrombosis","volume":"124","author":"Kirtane","year":"2011","journal-title":"Circulation"},{"key":"2023112515083530900_ytad565-B5","doi-asserted-by":"crossref","first-page":"3281","DOI":"10.1093\/eurheartj\/ehy285","article-title":"Clinical use of intracoronary imaging. Part 1: guidance and optimization of coronary interventions. An expert consensus document of the European Association of Percutaneous Cardiovascular Interventions","volume":"39","author":"Raber","year":"2018","journal-title":"Eur Heart J"},{"key":"2023112515083530900_ytad565-B6","doi-asserted-by":"crossref","first-page":"728","DOI":"10.1161\/CIRCULATIONAHA.120.052163","article-title":"Saphenous vein graft failure: from pathophysiology to prevention and treatment strategies","volume":"144","author":"Xenogiannis","year":"2021","journal-title":"Circulation"},{"key":"2023112515083530900_ytad565-B7","doi-asserted-by":"crossref","first-page":"e026849","DOI":"10.1161\/JAHA.122.026849","article-title":"The state of coronary thrombus aspiration","volume":"11","author":"Pruthi","year":"2022","journal-title":"J Am Heart Assoc"},{"key":"2023112515083530900_ytad565-B8","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1093\/eurheartj\/ehx393","article-title":"2017 ESC guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: the Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC)","volume":"39","author":"Ibanez","year":"2018","journal-title":"Eur Heart J"},{"key":"2023112515083530900_ytad565-B9","doi-asserted-by":"crossref","first-page":"614","DOI":"10.1016\/S0140-6736(13)61170-8","article-title":"Platelet reactivity and clinical outcomes after coronary artery implantation of drug-eluting stents (ADAPT-DES): a prospective multicentre registry study","volume":"382","author":"Stone","year":"2013","journal-title":"Lancet"},{"key":"2023112515083530900_ytad565-B10","doi-asserted-by":"crossref","first-page":"2520","DOI":"10.1056\/NEJMoa2111749","article-title":"Ticagrelor versus clopidogrel in CYP2C19 loss-of-function carriers with stroke or TIA","volume":"385","author":"Wang","year":"2021","journal-title":"N Engl J Med"},{"key":"2023112515083530900_ytad565-B11","doi-asserted-by":"crossref","first-page":"e0182124","DOI":"10.1371\/journal.pone.0182124","article-title":"A counseling program on nuisance bleeding improves quality of life in patients on dual antiplatelet therapy: a randomized controlled trial","volume":"12","author":"Biscaglia","year":"2017","journal-title":"PLoS One"},{"key":"2023112515083530900_ytad565-B12","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1038\/sj.clpt.6100139","article-title":"Cytochrome P450 3A inhibition by ketoconazole affects prasugrel and clopidogrel pharmacokinetics and pharmacodynamics differently","volume":"81","author":"Farid","year":"2007","journal-title":"Clin Pharmacol Ther"},{"key":"2023112515083530900_ytad565-B13","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1161\/CIRCULATIONAHA.109.921502","article-title":"Prasugrel","volume":"122","author":"Wiviott","year":"2010","journal-title":"Circulation"},{"key":"2023112515083530900_ytad565-B14","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1007\/s00228-019-02777-z","article-title":"Concomitant use of drugs known to cause interactions with oral antiplatelets-polypharmacy in acute coronary syndrome outpatients in Finland","volume":"76","author":"Prami","year":"2020","journal-title":"Eur J Clin Pharmacol"},{"key":"2023112515083530900_ytad565-B15","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1056\/NEJMoa1112277","article-title":"Rivaroxaban in patients with a recent acute coronary syndrome","volume":"366","author":"Mega","year":"2012","journal-title":"N Engl J Med"}],"container-title":["European Heart Journal - 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