Simultaneous Total Occlusion of Two Coronary Arteries Associated with Use of Drospirenon - Ethinyl Estradiol (Oral Contraceptive)

Abstract

Although the use of oral contraceptives is associated with an increased risk of venous thromboembolic disease, the risk of myocardial infarction (MI) is unclear. A new, third-generation contraceptive agent, drospirenone-ethinyl estradiol, which contains less estrogen and a new progestogen, drospirenone, in a different combination, has been considered more reliable in terms of risk of MI. However, there have been some cases of MI associated with the use of drospirenone-ethinyl estradiol, despite the protective effects of this oral contraceptive. In this report, a 33-year-old woman who had used drospirenone-ethinyl estradiol for 6 months was admitted with MI and symptoms of cardiogenic shock. Coronary angiography revealed the total occlusion of 2 coronary arteries and so percutaneous coronary intervention was performed. To the best of our knowledge, this is the first case report of simultaneous total occlusion of 2 coronary arteries associated with the use of drospirenone-ethinyl estradiol in the English-language medical literature.

A Fatal Case of Acute Thrombotic Occlusion in More Than 3 Epicardial Coronary Arteries Associated with the Yasmin Oral Contraceptive

“…The literature contains 3 case reports on Yasmin and MI but lacks information on the simultaneous occlusion of more than 3 epicardial coronary arteries. The simultaneous total occlusion of 2 coronary arteries (the left anterior descending and circumflex coronary arteries) was reported by Atmaca et al 7 In the reports of Orti 8 and Kocabay, 9 the culprit lesion was confined to 1 coronary artery. Currently, no guideline-based therapy exists for patients who develop MI during OCS use.…”

“…In another case, the diagnosis of the patient was acute anterolateral MI, treated with stenting for both coronary arteries and a tirofiban infusion. 7 Kocabay et al 9 used an intracoronary tissue plasminogen activator injection for the occluded left anterior descending coronary artery. They also used heparin with the tirofiban infusion for 48 hours.…”