Acute stent occlusion due to secondary thrombosis in a patient with romatoid arthritis

It has been known that rheumatoid arthritis is a risk factor for cardiovascular events. However, secondary thrombocytosis is not accepted as a risk factor for acute myocardial infarctus. We presented a case of acute myocardial infarction associated with secondary thrombocytosis. Primary percutaneous transluminal coronary angioplasty and stenting were performed due to acute myocardial infarction. Then, patient started to receive clopidogrel, aspirin, glycoprotein IIb/IIIa receptor blocker (trofiban) and standard heparin. But, repeated coronary angiography was required due to stent thrombosis, because persistent chest pain and ST elevation at anterior leads were observed approximately 4-6 hours after primary percutaneous transluminal coronary angioplasty. Repeated angiograph revealed acute stent restenosis and then the revascularization was achieved by balloon angioplasty.