Short‐Term Thrombosis Following Coronary Stent Implantation in a Patient With Myocardial Infarction and COVID‐19 Infection: A Case Report and Literature Review

In‐stent thrombosis is a rare but devastating complication following percutaneous coronary intervention, and its risk may be significantly heightened by the pro‐inflammatory and hypercoagulable state induced by COVID‐19 infection. This case report details a 62‐year‐old male with acute non‐ST‐elevation myocardial infarction who underwent successful drug‐eluting stent implantation, only to develop catastrophic in‐stent thrombosis and cardiac rupture within one hour post‐procedure, concurrent with a mild COVID‐19 infection. Despite emergency thrombectomy and surgical intervention, the patient succumbed to refractory cardiogenic shock. This case, alongside a review of similar published reports, underscores the alarmingly rapid onset of stent thrombosis in COVID‐19 patients and suggests that the viral infection acts as a potent precipitating factor. The pathophysiology likely involves immune‐mediated endothelial injury, platelet hyperreactivity, and a systemic inflammatory cascade. The discussion highlights the critical need for heightened vigilance, consideration of intensified peri‐procedural antithrombotic strategies (such as glycoprotein IIb/IIIa inhibitors), and the potential role of intravascular imaging in this high‐risk patient population. This report concludes that managing acute coronary syndrome in the context of COVID‐19 requires a personalized and aggressive approach to mitigate the elevated threat of early stent thrombosis.