Key result
Tailoring antiplatelets with platelet function tests may balance thrombotic and bleeding risks in recurrent ACS.
Why the study?
General guidelines are lacking for switching antiplatelet agents, particularly in the acute setting, in patients with acute coronary syndrome and very high thrombotic risk.
Case Report (n=1)
Tailoring antiplatelet therapy using platelet function tests may be necessary in complex patients with high thrombotic and bleeding risks.
Tailored antiplatelet switching may aid recurrent ACS with inflammation; hypothesis-generating for CBC-guided management pending prospective data.
Complete blood count should always be considered to tailor diagnosis and appropriate management in patients with acute ischemic heart disease. We present a challenging case of recurrent acute coronary syndrome, in the context of very high thrombotic risk due to concomitant inflammatory disease. Although no general guidelines exist for the switch between antiplatelet agents, particularly in the acute setting, in specific cases, the availability of different orally- and i.v.-acting agents and platelet function tests may allow to discriminate among multiple possible mechanisms of drug failure or side effects in the individual patient.
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Morici et al. (2019) conducted a case report in Recurrent acute coronary syndrome and ischemic colitis (n=1). Antiplatelet agents was evaluated. Tailoring antiplatelet therapy using different agents and platelet function tests may help manage competing thrombotic and bleeding risks in a patient with recurrent acute coronary syndrome.
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