{
  "abstract": "A 44-year-old man with suspected familial hypercholesterolemia underwent percutaneous coronary intervention (PCI) with bioresorbable polymer sirolimus-eluting stent implantation for unstable angina. A proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor was initiated post-procedure but it discontinued five months later due to financial constraints, leading to a loss to follow-up and cessation of optimal medical therapy, including antiplatelet therapy. Four years later, he developed stent thrombosis, presenting as ST-elevation myocardial infarction with cardiogenic shock. Emergency PCI with Impella support achieved successful revascularization. This case emphasizes that beyond clinical efficacy, attention to financial feasibility and shared decision-making is essential for the long-term success of therapies such as PCSK9 inhibitors.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": null,
  "arxiv": null,
  "author_total": 7,
  "authors": [
    {
      "name": "Tetsuro Nagao"
    },
    {
      "name": "Riku Arai"
    },
    {
      "name": "Tokio Nishiwaki"
    },
    {
      "name": "Yudai Tanaka"
    },
    {
      "name": "Koichiro Hori"
    },
    {
      "name": "Yasunari Ebuchi"
    },
    {
      "name": "Yasuo Okumura"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/4e9eszwr14jx7.bib",
  "cited_by": 0,
  "doi": "10.2169/internalmedicine.6453-25",
  "fulltext_url": "https://www.jstage.jst.go.jp/article/internalmedicine/65/16/65_6453-25/_article",
  "id": "4e9eszwr14jx7",
  "issns": [
    "1349-7235",
    "0918-2918"
  ],
  "landing_url": "https://www.jstage.jst.go.jp/article/internalmedicine/65/16/65_6453-25/_article",
  "language": null,
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "jstage-journal",
      "medicine/general"
    ],
    [
      "openalex",
      "2746|Coronary Interventions and Diagnostics"
    ]
  ],
  "openalex": "W7124150077",
  "pdf_url": "https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_6453-25/_pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-08-15",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/4e9eszwr14jx7.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:31Z",
      "native_id": "10.2169/internalmedicine.6453-25",
      "source": "jstage",
      "url": "https://www.jstage.jst.go.jp/article/internalmedicine/65/16/65_6453-25/_article"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Coronary Interventions and Diagnostics",
      "subfield": "surgery"
    }
  ],
  "title": "Acute Myocardial Infarction from Stent Thrombosis Following a Loss to Follow-up Triggered by Financial Barriers to PCSK9 Inhibitor Therapy",
  "title_text": "Acute Myocardial Infarction from Stent Thrombosis Following a Loss to Follow-up Triggered by Financial Barriers to PCSK9 Inhibitor Therapy",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:17:31Z",
  "url": "https://research.draconitic.com/paper/4e9eszwr14jx7",
  "venue": "Internal Medicine",
  "versions": []
}