Smukowska-Gorynia Anna, Mularek-Kubzdela Tatiana, Araszkiewicz Aleksander
1st Department of Cardiology, University of Medical Sciences, Poznan, Poland.
Blood Coagul Fibrinolysis. 2015 Jan;26(1):91-4. doi: 10.1097/MBC.0000000000000141.
The antiphosholipid syndrome (APS) is an autoimmune disorder, characterized by the presence of vascular thrombosis and/or pregnancy morbidity in a patient with positive laboratory tests for antiphospholipid antibodies. The patients with APS are in the high risk of rethrombosis. We report the case of 43-year-old female presenting with recurrent acute myocardial infarction with ST-segment elevation because of recurrent coronary thrombosis in coronary left anterior descending artery (LAD) and circumflex coronary artery (Cx) resulting in four percutaneous coronary interventions (PCI), associated with the presence of plasma antiphospholipid antibodies. Patient received seven stents to LAD and the aspiration of thrombus from Cx artery was performed. Pharmacotherapy included full antithrombotic treatment consisted with antiplatelet drugs such as: aspirin, clopidogrel followed by prasugrel, glycoprotein IIb/IIIa receptor antagonists and anticoagulants such as heparin followed by warfarin as well as steroids. At 1-year follow-up, controlled coronary angiography confirmed the good effect of PCI without any signs of stenosis or rethrombosis and highlighted the important role of antithrombotic treatment in patients with APS.
抗磷脂综合征（APS）是一种自身免疫性疾病，其特征为抗磷脂抗体实验室检查呈阳性的患者出现血管血栓形成和/或妊娠并发症。APS患者再次发生血栓形成的风险很高。我们报告了一例43岁女性病例，该患者因左冠状动脉前降支（LAD）和回旋支冠状动脉（Cx）反复发生冠状动脉血栓形成，导致复发性ST段抬高型急性心肌梗死，接受了四次经皮冠状动脉介入治疗（PCI），且存在血浆抗磷脂抗体。患者在LAD置入了七枚支架，并对Cx动脉进行了血栓抽吸。药物治疗包括全面的抗栓治疗，使用了抗血小板药物如阿司匹林、氯吡格雷，随后使用普拉格雷、糖蛋白IIb/IIIa受体拮抗剂，以及抗凝剂如肝素，随后使用华法林，还有类固醇。在1年的随访中，冠状动脉造影检查证实PCI效果良好，没有任何狭窄或再次血栓形成的迹象，并突出了抗栓治疗在APS患者中的重要作用。
