Epoetin Alfa: A Cause of Coronary Artery Thrombosis

Introduction. Epoetin alfa is an erythrocyte-stimulating factor. We here present a case of an anemic patient, who was given epogen before a coronary artery bypass (CABG) surgery and developed periprocedural myocardial infarction. To our knowledge, there has been no previous case reported of epogen c...

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Main Authors: Muhammad Umer Siddiqui, Yelena Galumyan, James Klein, Zunaira Naeem, Aron Schwarcz
Format: Article
Language:English
Published: Wiley 2017-01-01
Series:Case Reports in Cardiology
Online Access:http://dx.doi.org/10.1155/2017/9475180
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author Muhammad Umer Siddiqui
Yelena Galumyan
James Klein
Zunaira Naeem
Aron Schwarcz
author_facet Muhammad Umer Siddiqui
Yelena Galumyan
James Klein
Zunaira Naeem
Aron Schwarcz
author_sort Muhammad Umer Siddiqui
collection DOAJ
description Introduction. Epoetin alfa is an erythrocyte-stimulating factor. We here present a case of an anemic patient, who was given epogen before a coronary artery bypass (CABG) surgery and developed periprocedural myocardial infarction. To our knowledge, there has been no previous case reported of epogen causing myocardial infarction. Case Presentation. 66-year-old female presented with substernal chest pain. EKG showed ST segment elevations in aVf and L-III. Patient underwent left heart catheterization (LHC) and had triple vessel disease. A bare metal stent was placed in RCA. Patient continued to have symptoms after discharge and presented to the ED again with these complaints. She underwent coronary artery bypass surgery (CABG). Before the procedure, patient’s hemoglobin was 11.1 grams/deciliter and was given epogen to raise hemoglobin level. Postoperative day (POD) #1 patient had ST elevations in inferior and anterolateral leads. She was diagnosed with periprocedural myocardial infarction. Patient underwent repeat LHC, which identified obstruction of saphenous vein graft (SVG). Hypercoagulable workup was negative for any disease and the patient was diagnosed with epogen induced early graft occlusion. Conclusion. Epogen administration can cause myocardial infarction and coronary artery thrombosis. We suggest that physicians use epogen very cautiously, especially in population who has underlying coronary artery disease.
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spelling doaj-art-ce614410cd394047a098194206eebbef2025-08-20T03:19:38ZengWileyCase Reports in Cardiology2090-64042090-64122017-01-01201710.1155/2017/94751809475180Epoetin Alfa: A Cause of Coronary Artery ThrombosisMuhammad Umer Siddiqui0Yelena Galumyan1James Klein2Zunaira Naeem3Aron Schwarcz4Lakeview Medical Center, Marshfield Clinic, Rice Lake, WI, USAEnglewood Hospital and Medical Center, Englewood, NJ, USAEnglewood Hospital and Medical Center, Englewood, NJ, USADOW Medical College, Karachi, PakistanEnglewood Hospital and Medical Center, Englewood, NJ, USAIntroduction. Epoetin alfa is an erythrocyte-stimulating factor. We here present a case of an anemic patient, who was given epogen before a coronary artery bypass (CABG) surgery and developed periprocedural myocardial infarction. To our knowledge, there has been no previous case reported of epogen causing myocardial infarction. Case Presentation. 66-year-old female presented with substernal chest pain. EKG showed ST segment elevations in aVf and L-III. Patient underwent left heart catheterization (LHC) and had triple vessel disease. A bare metal stent was placed in RCA. Patient continued to have symptoms after discharge and presented to the ED again with these complaints. She underwent coronary artery bypass surgery (CABG). Before the procedure, patient’s hemoglobin was 11.1 grams/deciliter and was given epogen to raise hemoglobin level. Postoperative day (POD) #1 patient had ST elevations in inferior and anterolateral leads. She was diagnosed with periprocedural myocardial infarction. Patient underwent repeat LHC, which identified obstruction of saphenous vein graft (SVG). Hypercoagulable workup was negative for any disease and the patient was diagnosed with epogen induced early graft occlusion. Conclusion. Epogen administration can cause myocardial infarction and coronary artery thrombosis. We suggest that physicians use epogen very cautiously, especially in population who has underlying coronary artery disease.http://dx.doi.org/10.1155/2017/9475180
spellingShingle Muhammad Umer Siddiqui
Yelena Galumyan
James Klein
Zunaira Naeem
Aron Schwarcz
Epoetin Alfa: A Cause of Coronary Artery Thrombosis
Case Reports in Cardiology
title Epoetin Alfa: A Cause of Coronary Artery Thrombosis
title_full Epoetin Alfa: A Cause of Coronary Artery Thrombosis
title_fullStr Epoetin Alfa: A Cause of Coronary Artery Thrombosis
title_full_unstemmed Epoetin Alfa: A Cause of Coronary Artery Thrombosis
title_short Epoetin Alfa: A Cause of Coronary Artery Thrombosis
title_sort epoetin alfa a cause of coronary artery thrombosis
url http://dx.doi.org/10.1155/2017/9475180
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AT yelenagalumyan epoetinalfaacauseofcoronaryarterythrombosis
AT jamesklein epoetinalfaacauseofcoronaryarterythrombosis
AT zunairanaeem epoetinalfaacauseofcoronaryarterythrombosis
AT aronschwarcz epoetinalfaacauseofcoronaryarterythrombosis