What is responsible for acute myocardial infarction in combination with aplastic anemia? A case report and literature review  

作　　者：Ya-Nan Zhao Wei-Wei Chen Xiao-Yu Yan Kun Liu Guo-Hui Liu Ping Yang 

机构地区：[1]Department of Cardiology,China-Japan Union Hospital of Jilin University,Changchun 130000,Jilin Province,China [2]Department of Cardiology,Jilin Provincial Cardiovascular Research Institute,Changchun 130000,Jilin Province,China [3]Department of Cardiology,Jilin Provincial Engineering Laboratory for Endothelial Function and Genetic Diagnosis of Cardiovascular Disease,Changchun 130000,Jilin Province,China

出　　处：《World Journal of Clinical Cases》2022年第32期11955-11966,共12页世界临床病例杂志

基　　金：Supported by the project from Provincial Science and Technology Department,No.2019SC0012。

摘　　要：BACKGROUND Aplastic anemia(AA)complicated with myocardial infarction(MI)is rare and associated with poor prognosis.Here,we present a case of AA with recurrent acute MI(AMI)in a patient treated with cyclosporine A(CsA)and stanozolol.In this patient,we suspect the long-term use of medication linked to platelets hyperfunction.CASE SUMMARY In 2017,a 45-year-old man was rushed to the emergency department of China-Japan Union Hospital due to precordial pain for 5 h.Based on his symptoms,medical history,blood tests,and findings from coronary angiography(CAG),the patient was diagnosed with acute anterior wall,ST-segment elevated MI,Killip II grade,AA,and dyslipidemia.In 2021,the patient was readmitted to the hospital for 2 h due to chest pain.Because the patient’s platelet count was 30×109/L and he had severe thrombocytopenia,we performed CAG following platelet transfusion.Optical coherence tomography revealed lipid plaque and thrombus mass in his right coronary artery.The antithrombotic approach was adjusted to employ only anticoagulants(factor Xa inhibitors)and adenosine diphosphate inhibitors(clopidogrel)after assessing the risk of bleeding/thrombotic events.Long-term follow-up revealed that the patient had made a good recovery.CONCLUSION Patients with AA should be closely monitored for the risk of thrombosis and cardiovascularevents, particularly when taking stanozolol or CsA for an extended period of time.

关 键 词：Aplastic anemia Myocardial infarction Cyclosporine A STANOZOLOL Percutaneous coronary intervention Case report 

分 类 号：R542.22[医药卫生—心血管疾病] R556.5[医药卫生—内科学]