Subacute stent thrombosis occurring more than one month after implantationfor acute myocardial infarction

Two patients are described with anterior acute myocardial infarction who ha d a successful recanalization of a totally occluded left anterior descendin g coronary artery by means of primary angioplasty and stenting. Reinfarctio n occurred more than 1 month after implantation. At angiography, a totally occluded left anterior descending coronary artery at the site of stenting w as observed and was effectively reopened with angioplasty and stenting in b oth cases. This report aims to emphasize that acute myocardial infarction s till represents a major risk factor for subacute stent thrombosis and that this potentially catastrophic event may occur late after implantation. Pote ntial implications for revascularization strategies and medical treatment a re discussed.