There have been multiple case reports of patients who have had coronary stents who have been on clopidogrel for > 1 year who have developed coronary thrombosis after clopidogrel cessation. There are also reports of patients who have developed DVTs likewise after clopidogrel cessation. In vivo studies in diabetics have demonstrated increased platelet and inflammatory markers after clopidogrel withdrawal. It appears that abrupt discontinuation of clopidogrel may lead to a thrombotic state in susceptible patients.
References
1. Di Micco, B. Di Micco G,et all. Proximal deep vein thrombosis occuring after sudden clopidogrel suspension. Eur J Clin Pharmacol 2004;60:63-4. 2. Angilillo D, et al. Clopidogrel withdrawal is associated with proinflammatory and prothrombotic effects in patients with diabetes and coronary artery disease. Diabetes. March 2006;55(3):780-4. 3. Chrissoheris M, Mruthyunjayanna V, Dononhue T. Late thrombosis of drug-eluting stets after discontinuation of clobidogrel: Report of two cases and review of the literature. Connecticut Medicine, Sept 2006;70(8):485-9.
