Primary Percutaneous Coronary Intervention for Acute Myocardial Infarction in a Young Female with Idiopathic Thrombocytopenic Purpura: A Case Report and Review

Yıldız, Ahmet; Coşkun, Uğur; Batukan, Ozlem Esen; Keskin, Kudret

doi:10.1155/2010/854682

Cited by 11 publications

(8 citation statements)

References 12 publications

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“…Perioperative ITP treatment certainly minimized the complication rate in the PCI population as well. The first-line option was STER [25,29,31], but if a rapid platelet count elevation were required, IVIG supplementation [32,38,39] could be administered. Great attention must be paid when administering such therapies because of the increased risk of myocardial infarction.…”

Section: Discussionmentioning

confidence: 99%

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Idiopathic thrombocytopenic purpura and coronary artery disease: comparison between coronary artery bypass grafting and percutaneous coronary intervention

Russo

Cannizzo

Ghetti

et al. 2011

Interactive CardioVascular and Thoracic Surgery

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Idiopathic thrombocytopenic purpura (ITP) is an autoimmune disorder characterized by a low platelet count and an increased risk of bleeding. At the same time, ITP patients present an increased risk of thrombosis and atherosclerosis related to the high presence of haemostatic factors and chronic steroid therapy. Although relatively rare, the association of ITP and coronary artery disease represents a complex therapeutic challenge. In particular, no recommendations exist regarding the best management approach. We reviewed the literature making a comparison between coronary artery bypass grafting and percutaneous coronary intervention.

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Section: Discussionmentioning

confidence: 99%

“…From 1999 to January 2010, 15 cases of patients affected by ITP who underwent PCI were reported ( Table 2) [25][26][27][28][29][30][31][32][33][34][35][36][37][38][39].…”

Section: Pci In Patients With Itpmentioning

confidence: 99%

Idiopathic thrombocytopenic purpura and coronary artery disease: comparison between coronary artery bypass grafting and percutaneous coronary intervention

Russo

Cannizzo

Ghetti

et al. 2011

Interactive CardioVascular and Thoracic Surgery

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“…At least 20 patients (1 from personal files and 19 from the literature) with ITP were found to have had arterial thrombosis (15 MI, 2 unstable angina, 2 ischemic stroke, and 1 peripheral arteries thrombosis). 4,6,8,11 –27 Another patient, from personal files, had to be excluded because at time of thrombosis (MI), the platelet level was 100 × 10 3 /μL. 28 Age varied between 37 and 80.…”

Section: Resultsmentioning

confidence: 99%

Arterial and Venous Thromboses in Patients With Idiopathic (Immunological) Thrombocytopenia

Girolami

Marinis

Bonamigo

et al. 2012

Clin Appl Thromb Hemost

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Immunological thrombocytopenias, as other forms of thrombocytopenia, are associated with bleeding. Occasionally, these patients manifest thrombotic events. A total of at least 29 patients were reported to have had either arterial (20 cases) or venous (9 cases) thrombosis while platelet count was less than 50 × 10(3)/μL. The most frequent clinical manifestation was a myocardial infarction. Thrombosis occurred in the large majority of patients during prednisone therapy. Patients receiving cortisone or patients with Cushing syndrome show a hypercoagulable state characterized by elevated factor VIII levels, decreased fibrinolysis, and abnormal von Willebrand factor multimers composition. The same is probably true for prednisone-treated patients with thrombocytopenia. However, the 2 conditions are not identical since prednisone is a mainly glycoactive compound, whereas cortisol produced in excess in Cushing syndrome is mainly mineraloactive. The presence of large, young, hyperactive platelets may also play a role. Prednisone-treated patients with thrombocytopenia have to be considered as potentially thrombophilic.

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“…Já os antiplaquetários podem ser administrados, nas doses de ataque e de manutenção usuais. [4][5][6]8 Entre os tienopiridínicos, o clopidogrel é considerado mais seguro que a ticlopidina, pela menor incidência de efeitos hematológicos adversos. É importante monitorar o número de plaquetas nesses pacientes, especialmente nos primeiros três meses, e acompanhar o aparecimento eventual de sangramentos, que pode acarretar a suspensão desses fármacos.…”

Section: Discussionunclassified

“…O tratamento nesse cenário é um desafio, uma vez que a antiagregação e a anticoagulação aumentam o risco de sangramento nesses pacientes, e o uso de trombolíticos é contraindicado. [5][6][7] …”

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Angioplastia coronária em paciente com infarto do miocárdio e púrpura trombocitopênica idiopática

Ortencio¹,

Liguori²,

Albuquerque³

et al. 2010

Rev. Bras. Cardiol. Invasiva

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A púrpura trombocitopênica idiopática, também conhecida como púrpura trombocitopênica imune ou doença de Werlhof 1 , é uma doença rara, com incidência na população geral variando de 1,6 caso a 15,5 casos por 100 mil pessoas por ano. Sua etiologia é autoimune e caracterizada pela presença de autoanticorpos que se ligam na superfície das plaquetas, levando a seu sequestro no sistema reticuloendotelial. Manifesta-se clinicamente por baixa contagem de plaquetas e tendência a sangramentos mucocutâneos. 2-4 ABSTRACT Coronary Angioplasty in a Patient with Myocardial Infarction and Idiopathic Thrombocytopenic PurpuraIdiopathic thrombocytopenic purpura (ITP) is an autoimmune disorder characterized by the presence of thrombocytopenia and mucocutaneous bleeding. It is a rare condition and the occurrence of an acute myocardial infarction (AMI) in patients with ITP is even less common. In the present manuscript the authors report a patient with ITP who underwent percutaneous transluminal coronary angioplasty in the follow-up phase of an AMI. KEY-WORDS:Purpura, thrombocytopenic, idiopathic. Angioplasty, transluminal, percutaneous coronary. Myocardial infarction. RESUMOA púrpura trombocitopênica idiopática (PTI) é um distúr-bio autoimune, caracterizado clinicamente por plaquetopenia e sangramentos mucocutâneos. Trata-se de doença rara na população geral e a ocorrência de infarto agudo do miocárdio (IAM) em pacientes com PTI é ainda menos frequente. Neste artigo os autores descrevem um caso com PTI no qual foi praticada angioplastia coronária transluminal na fase evolutiva do IAM. DESCRITORES:Púrpura trombocitopênica idiopática. Angioplastia transluminal percutânea coronária. Infarto do miocárdio.A coexistência de púrpura trombocitopênica idiopática com doença aterosclerótica é possível, porém sua associação com infarto agudo do miocárdio é incomum, em decorrência do papel decisivo que as plaquetas desempenham nos eventos trombóticos. O tratamento nesse cenário é um desafio, uma vez que a antiagregação e a anticoagulação aumentam o risco de sangramento nesses pacientes, e o uso de trombolíticos é contraindicado. [5][6][7]

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Primary Percutaneous Coronary Intervention for Acute Myocardial Infarction in a Young Female with Idiopathic Thrombocytopenic Purpura: A Case Report and Review

Cited by 11 publications

References 12 publications

Idiopathic thrombocytopenic purpura and coronary artery disease: comparison between coronary artery bypass grafting and percutaneous coronary intervention

Idiopathic thrombocytopenic purpura and coronary artery disease: comparison between coronary artery bypass grafting and percutaneous coronary intervention

Arterial and Venous Thromboses in Patients With Idiopathic (Immunological) Thrombocytopenia

Angioplastia coronária em paciente com infarto do miocárdio e púrpura trombocitopênica idiopática

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