To the Editor: We read with great interest the case report by Barthwal and Herman,1 and agree with many of the points they raise. In-stent thrombosis after cessation of clopidogrel therapy in patients with drug-eluting stents (DES) is a significant problem in Australian medical practice, particularly in the perioperative period,2-4 as the case report by Barthwal and Herman confirms.1
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- Department of Anaesthesia, Perioperative and Pain Medicine, The Geelong Hospital, Geelong, VIC.
Correspondence: steveb@barwonhealth.org.au
- 1. Barthwal R, Herman BA. Very late stent thrombosis after discontinuation of clopidogrel therapy. Med J Aust 2008; 189: 229-230. <eMJA full text> <MJA full text>
- 2. Kaluza GL, Joseph J, Lee JR, et al. Catastrophic outcomes of noncardiac surgery soon after coronary stenting. J Am Coll Cardiol 2000; 35: 1288-1294.
- 3. Broad L, Lee T, Conroy M, et al. Successful management of patients with a drug-eluting coronary stent presenting for elective, non-cardiac surgery. Br J Anaesth 2007; 98: 19-22.
- 4. Conroy M, Bolsin SN, Black SA, Orford N. Perioperative complications in patients with drug-eluting stents: a three-year audit at Geelong Hospital. Anaesth Intensive Care 2007; 35: 939-944.
- 5. Purkayasth S, Athanasiou T, Malinovski V, et al. Does clopidogrel affect outcome after coronary artery bypass grafting? A meta-analysis. Heart 2006; 92: 531-532.
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