UNEXPECTED THREAT: RARE EVENT OF LATE STENT THROMBOSIS

Authors

  • Afonso Carvalhal Médico Interno de Formação Específica em Medicina Geral e Familiar
  • Márcia Moreira Costa Médico Interno de Formação Específica em Medicina Geral e Familiar
  • Ana Raquel Dias Médico Interno de Formação Específica em Medicina Geral e Familiar
  • Anabela Andrade Médico Especialista em Medicina Geral e Familiar
  • Ana Margarida Adão Médico Especialista em Medicina Geral e Familiar
  • Ângela Costa Médico Especialista em Medicina Geral e Familiar

DOI:

https://doi.org/10.58043/rphrc.116

Abstract

Acute myocardial infarction (AMI) is a prevalent and high mortality condition. Addressing and optimizing cardiovascular risk factors is essential to reduce the risk of cardiovascular events. The intervention in the acute phase of this pathology implies direct costs associated with treatment, hospitalization, rehabilitation and follow-up, but also indirect costs such as work absenteeism and decreased quality of life. AMI may be associated with other comorbidities, such as atrial fibrillation in 20% of cases, increasing therapeutic complexity. The risk of AMI recurrence is increased in patients with previous AMI, but stent thrombosis is a rare entity, and even rarer is stent thrombosis more than 1 year after intervention. AMI due to stent thrombosis appear to have more severe outcomes than AMI due to atherosclerotic plaque rupture. This case demonstrates that, even after optimizing the control of cardiovascular risk factors after the first event of AMI, the risk of recurrence is not negligible, and entities such as stent thrombosis may occur in any time period. Our aim is to highlight the importance of the multidisciplinary approach in the follow-up of these patients. The control of risk factors and therapy optimization are essential to reduce the likelihood of a new event, despite the fact that it is not always possible to completely eliminate this risk.

Downloads

Download data is not yet available.

References

Visseren FLJ, Mach F, Smulders YM, Carballo D, Koskinas KC, Bäck M, et al. 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice. Eur Heart J. 2021; 42: 3227-3337.

Bishu KG, Lekoubou A, Kirkland E, Schumann SO, Schreiner A, Heincelman M, Moran WP, Mauldin PD, Estimating the Economic Burden of Acute Myocardial Infarction in the US: 12 Year National Data. Am J Med Qual. 2020; 359(5): 257-265. https://doi.org/10.1016/j.amjms.2020.02.004

Jernberg T, Hasvold P, Henriksson M, Hjelm H, Thuresson M, Janzon M, Cardiovascular risk in post-myocardial infarction patients: nationwide real world data demonstrate the importance of a long-term perspective. Eur Heart J. 2015;36(19): 1163-70. 10.1093/eurheartj/ehu505

Hindricks G, Potpara T, Dagres N, Arbelo E, Bax JJ, Blomström-Lundqvist C, et al. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J. 2021; 42(5): 373-498.

Donald C, Abbott JD, Coronary artery stent thrombosis: Incidence and risk factors - UpToDate. UpToDate. Available at: https://www.uptodate.com/ contents/coronary-artery-stent-thrombosis-incidence-and-risk-factors [accessed 25 May 2023]

Donald C, Coronary artery stent thrombosis: Clinical presentation and management. UpToDate. Available at: https://www.uptodate.com/contents/coronary-artery-stent-thrombosis-clinical-presentation-and-management [accessed 25 May 2023]

Ibanez B, James S, Agewall S, Antunes MJ, Bucciarelli-Ducci C, Bueno H. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J. 2018; 39(2): 119–177.

Published

2024-01-28

How to Cite

1.
Carvalhal A, Moreira Costa M, Dias AR, Andrade A, Adão AM, Costa Ângela. UNEXPECTED THREAT: RARE EVENT OF LATE STENT THROMBOSIS. RH [Internet]. 2024 Jan. 28 [cited 2024 Dec. 22];(99):36-9. Available from: https://revistahipertensao.pt/index.php/rh/article/view/116

Issue

Section

Caso Clínico