Recurrent Acute Coronary Syndromes in a Patient with Idiopathic Thrombocytopenic Purpura
A 53-year-old man was admitted to a peripheral hospital with the diagnosis of acute myocardial infarction without ST elevation. Due to the concomitant presence of first-diagnosed thrombocytopenia (platelet count 50.000/μL), it was decided to be treated conservatively with clopidogrel. Five days late...
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| Format: | Article |
| Language: | English |
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Wiley
2020-01-01
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| Series: | Case Reports in Cardiology |
| Online Access: | http://dx.doi.org/10.1155/2020/6738348 |
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| author | Nikolaos Iakovis Andrew Xanthopoulos Aikaterini Chamaidi Michail Papamichalis Apostolos Dimos Filippos Triposkiadis John Skoularigis |
| author_facet | Nikolaos Iakovis Andrew Xanthopoulos Aikaterini Chamaidi Michail Papamichalis Apostolos Dimos Filippos Triposkiadis John Skoularigis |
| author_sort | Nikolaos Iakovis |
| collection | DOAJ |
| description | A 53-year-old man was admitted to a peripheral hospital with the diagnosis of acute myocardial infarction without ST elevation. Due to the concomitant presence of first-diagnosed thrombocytopenia (platelet count 50.000/μL), it was decided to be treated conservatively with clopidogrel. Five days later, he developed an acute myocardial infarction with ST elevation (STEMI) and was transferred to our department for primary percutaneous coronary intervention (PCI). Coronary angiography revealed three-vessel disease. The left anterior descending lesion was considered culprit, and PCI was successfully performed using a drug-eluting balloon. This approach was considered safer due to the risk of intolerance of prolonged dual antiplatelet therapy in case of stent implantation. Indeed, four days later, aspirin was discontinued, and the patient remained only on clopidogrel due to a platelet fall. Meanwhile, idiopathic thrombocytopenic purpura (ITP) was diagnosed by hematology consultation, and specific ITP treatment was initiated. Seven days following the procedure, the patient was transferred to the Hematology clinic, where a continuous rise of platelet count up to 115.000/μL while on clopidogrel was observed, and he was discharged from the hospital asymptomatic. Unfortunately, twenty days later, the patient died of a lung infection. In ITP patients with STEMI, primary PCI with drug-eluting balloon angioplasty may be a reasonable approach. |
| format | Article |
| id | doaj-art-6f3a3b5c0f894d518a0b43b2be8f7262 |
| institution | OA Journals |
| issn | 2090-6404 2090-6412 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
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| series | Case Reports in Cardiology |
| spelling | doaj-art-6f3a3b5c0f894d518a0b43b2be8f72622025-08-20T02:06:23ZengWileyCase Reports in Cardiology2090-64042090-64122020-01-01202010.1155/2020/67383486738348Recurrent Acute Coronary Syndromes in a Patient with Idiopathic Thrombocytopenic PurpuraNikolaos Iakovis0Andrew Xanthopoulos1Aikaterini Chamaidi2Michail Papamichalis3Apostolos Dimos4Filippos Triposkiadis5John Skoularigis6Department of Cardiology, University General Hospital of Larissa, Larissa, GreeceDepartment of Cardiology, University General Hospital of Larissa, Larissa, GreeceDepartment of Cardiology, University General Hospital of Larissa, Larissa, GreeceDepartment of Cardiology, University General Hospital of Larissa, Larissa, GreeceDepartment of Cardiology, University General Hospital of Larissa, Larissa, GreeceDepartment of Cardiology, University General Hospital of Larissa, Larissa, GreeceDepartment of Cardiology, University General Hospital of Larissa, Larissa, GreeceA 53-year-old man was admitted to a peripheral hospital with the diagnosis of acute myocardial infarction without ST elevation. Due to the concomitant presence of first-diagnosed thrombocytopenia (platelet count 50.000/μL), it was decided to be treated conservatively with clopidogrel. Five days later, he developed an acute myocardial infarction with ST elevation (STEMI) and was transferred to our department for primary percutaneous coronary intervention (PCI). Coronary angiography revealed three-vessel disease. The left anterior descending lesion was considered culprit, and PCI was successfully performed using a drug-eluting balloon. This approach was considered safer due to the risk of intolerance of prolonged dual antiplatelet therapy in case of stent implantation. Indeed, four days later, aspirin was discontinued, and the patient remained only on clopidogrel due to a platelet fall. Meanwhile, idiopathic thrombocytopenic purpura (ITP) was diagnosed by hematology consultation, and specific ITP treatment was initiated. Seven days following the procedure, the patient was transferred to the Hematology clinic, where a continuous rise of platelet count up to 115.000/μL while on clopidogrel was observed, and he was discharged from the hospital asymptomatic. Unfortunately, twenty days later, the patient died of a lung infection. In ITP patients with STEMI, primary PCI with drug-eluting balloon angioplasty may be a reasonable approach.http://dx.doi.org/10.1155/2020/6738348 |
| spellingShingle | Nikolaos Iakovis Andrew Xanthopoulos Aikaterini Chamaidi Michail Papamichalis Apostolos Dimos Filippos Triposkiadis John Skoularigis Recurrent Acute Coronary Syndromes in a Patient with Idiopathic Thrombocytopenic Purpura Case Reports in Cardiology |
| title | Recurrent Acute Coronary Syndromes in a Patient with Idiopathic Thrombocytopenic Purpura |
| title_full | Recurrent Acute Coronary Syndromes in a Patient with Idiopathic Thrombocytopenic Purpura |
| title_fullStr | Recurrent Acute Coronary Syndromes in a Patient with Idiopathic Thrombocytopenic Purpura |
| title_full_unstemmed | Recurrent Acute Coronary Syndromes in a Patient with Idiopathic Thrombocytopenic Purpura |
| title_short | Recurrent Acute Coronary Syndromes in a Patient with Idiopathic Thrombocytopenic Purpura |
| title_sort | recurrent acute coronary syndromes in a patient with idiopathic thrombocytopenic purpura |
| url | http://dx.doi.org/10.1155/2020/6738348 |
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