Two cases of acute coronary syndrome that occurred by preoperative discontinuation of antiplatelet therapy in the chronic phase after stent implantation

SummaryAfter stent implantation in the coronary arteries, patients sometimes have to undergo invasive examination or treatments that mandate discontinuation of antiplatelet therapy for several days. We encountered two cases of acute coronary syndrome that occurred after preoperative discontinuation of antiplatelet agents in the chronic phase after stent implantation. In the first case, antiplatelet agents were temporarily stopped 5 months after the implantation of a bare metal stent (BMS) in preparation for a kidney transplant. In the second case, antiplatelet agents were stopped 1.5 months after BMS implantation in preparation for esophageal bypass surgery. In both cases, acute myocardial infarction occurred just after the invasive operation, despite the fact that they had continued dual antiplatelet therapy for the period recommended by the American Heart Association/American College of Cardiology guideline. This report provides a warning about the temporary discontinuation of antiplatelet agents even in the chronic stage of coronary stent implantation.