1. [A man in his sixties with myocardial infarction, stent thrombosis and haemorrhage].
- Author
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Tjugen TB, Eritsland J, Mangschau A, and Andersen GØ
- Subjects
- Abciximab, Angioplasty, Balloon, Antibodies, Monoclonal adverse effects, Antibodies, Monoclonal therapeutic use, Anticoagulants therapeutic use, Coronary Artery Bypass, Coronary Disease diagnosis, Coronary Disease therapy, Coronary Thrombosis diagnosis, Coronary Thrombosis etiology, Hematuria complications, Humans, Immunoglobulin Fab Fragments adverse effects, Immunoglobulin Fab Fragments therapeutic use, Male, Middle Aged, Myocardial Infarction diagnosis, Myocardial Infarction drug therapy, Recurrence, Thrombocytopenia chemically induced, Urinary Bladder Neoplasms complications, Anticoagulants adverse effects, Coronary Thrombosis drug therapy, Hemorrhage chemically induced, Myocardial Infarction therapy, Stents adverse effects
- Abstract
A man in his sixties had acute ST-elevation myocardial infarction (treated with PCI [percutaneous coronary intervention] and antithrombotic medication) complicated by recurrent stent thrombosis. Excessive haematuria and discovery of a urinary bladder cancer complicated the antithrombotic treatment. Due to recurrent stent thrombosis the patient underwent a total of four PCIs and received the glycoprotein IIb/IIIa-inhibitor abciximab on two occasions. After the last administration of abciximab he developed excessive bleeding within an hour; a blood sample revealed severe thrombocytopenia (2 x 10(9)/l). Severe thrombocytopenia is a rare, but well-known complication to glycoprotein IIb/IIIa-inhibitor treatment and is most often seen after readministration of abciximab. The problem of recurrent coronary stent thrombosis was solved by aorto-coronary bypass surgery, which should always be considered in patients with recurrent stent thrombosis and complications to anti-thrombotic treatment. When bleeding occurs in connection with abciximab treatment, especially within the first month after previous treatment, severe thrombocytopenia should always be considered as a possible cause. Abciximab should be avoided in patients with a history of severe abciximab-related thrombocytopenia.
- Published
- 2010
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