Recurrent myocardial infarction due to one subacute and two very late thrombotic events of drug-eluting stent associated with clopidogrel resistance.

Although drug-eluting stent (DES) thrombosis is a recognized complication of coronary intervention, recurrent late stent thrombosis is rarely reported. Clopidogrel resistance or low-responsiveness may be associated with recurrent late stent thrombosis after DES implantation. We present a diabetic patient with hypertension, obesity and heavy smoking history, who suffered 3 recurrent attacks of acute anterior ST-segment elevation myocardial infarction over 6 years due to recurrent thromboses of DES despite prolonged and regular triple antiplatelet therapy. Laboratory evaluation of hypercoagulability yielded negative results, but low responsiveness for clopidogrel was revealed by the VerifyNow P2Y12 assay.