Insights for increased risk of failed fibrinolytic therapy and stent thrombosis associated with COVID-19 in ST-segment elevation myocardial infarction patients.
Identifieur interne : 000C71 ( Main/Exploration ); précédent : 000C70; suivant : 000C72Insights for increased risk of failed fibrinolytic therapy and stent thrombosis associated with COVID-19 in ST-segment elevation myocardial infarction patients.
Auteurs : Thibaud Lacour [France] ; Carl Semaan [France] ; Thibaud Genet [France] ; Fabrice Ivanes [France]Source :
- Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions [ 1522-726X ] ; 2020.
Abstract
Important health resources are dedicated worldwide to the management of COVID-19. This new disease, due to its large diffusion, may significantly hamper the prognosis of other pathologies, such as ST-segment elevation myocardial infarction (STEMI) because of (a) a possible direct negative impact and (b) shortage of first response medical resources and increased delays to reperfusion. We report the case of a 68-year-old man admitted for anterior STEMI and asymptomatic COVID-19. Due to extended transportation delays to a cathlab, he received intravenous fibrinolytic therapy, which failed. Reperfusion was achieved with rescue coronary angioplasty, but the patient experienced two episodes of acute stent thrombosis at 2- and 36-hr following admission and despite optimal medical therapy. He finally died because of cardiogenic shock. This raises concerns about a possible increase in platelet aggregability associated with COVID-19 leading to an increased risk of stent thrombosis, particularly in the context of STEMI. This pleads for the promotion of primary coronary angioplasty as the first-choice revascularization technique in this population and the use of new generation P2Y12 inhibitors. In addition, the use of GPIIb/IIIa inhibitors may be considered in every STEMI patient with COVID-19 to prevent the risk of acute stent thrombosis.
DOI: 10.1002/ccd.28948
PubMed: 32352633
PubMed Central: PMC7267248
Affiliations:
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Tours</orgName></affiliation></author></analytic><series><title level="j">Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions</title><idno type="eISSN">1522-726X</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Important health resources are dedicated worldwide to the management of COVID-19. 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This pleads for the promotion of primary coronary angioplasty as the first-choice revascularization technique in this population and the use of new generation P2Y12 inhibitors. In addition, the use of GPIIb/IIIa inhibitors may be considered in every STEMI patient with COVID-19 to prevent the risk of acute stent thrombosis.</div></front></TEI><pubmed><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">32352633</PMID><DateRevised><Year>2020</Year><Month>09</Month><Day>09</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1522-726X</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2020</Year><Month>Apr</Month><Day>30</Day></PubDate></JournalIssue><Title>Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions</Title><ISOAbbreviation>Catheter Cardiovasc Interv</ISOAbbreviation></Journal><ArticleTitle>Insights for increased risk of failed fibrinolytic therapy and stent thrombosis associated with COVID-19 in ST-segment elevation myocardial infarction patients.</ArticleTitle><ELocationID EIdType="doi" ValidYN="Y">10.1002/ccd.28948</ELocationID><Abstract><AbstractText>Important health resources are dedicated worldwide to the management of COVID-19. This new disease, due to its large diffusion, may significantly hamper the prognosis of other pathologies, such as ST-segment elevation myocardial infarction (STEMI) because of (a) a possible direct negative impact and (b) shortage of first response medical resources and increased delays to reperfusion. We report the case of a 68-year-old man admitted for anterior STEMI and asymptomatic COVID-19. Due to extended transportation delays to a cathlab, he received intravenous fibrinolytic therapy, which failed. Reperfusion was achieved with rescue coronary angioplasty, but the patient experienced two episodes of acute stent thrombosis at 2- and 36-hr following admission and despite optimal medical therapy. He finally died because of cardiogenic shock. This raises concerns about a possible increase in platelet aggregability associated with COVID-19 leading to an increased risk of stent thrombosis, particularly in the context of STEMI. This pleads for the promotion of primary coronary angioplasty as the first-choice revascularization technique in this population and the use of new generation P2Y12 inhibitors. 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