Department of Cardiology, Nanjing First Hospital, Nanjing Medical University , Nanjing, Jiangsu, China.
Platelets. 2020 Aug 17;31(6):815-819. doi: 10.1080/09537104.2019.1665640. Epub 2019 Sep 10.
Essential thrombocythemia (ET) can cause systemic vascular thrombosis, but the involvement of coronary arteries is rare. This study is aimed to analyze the characteristics, treatment, and prognosis during follow-up in patients with ET after percutaneous coronary intervention (PCI). A total of eight patients with ET who had coronary heart disease and treated with PCI in our hospital from 2012 to 2018 were retrospectively studied. The basic clinical information with clinical data, data of coronary intervention, application of anti-platelet and platelet reducing drugs, and the results of long-term follow-up were recorded. There were five males and three females with a median age of 67 years. Clinical presentation was unstable angina in four cases, stable angina in one case, ST-elevation myocardial infarction in two cases, and non-ST elevation myocardial infarction in one case. The average platelet count was 722 × 10/L in admission, and hydroxyurea was used in seven cases. Coronary angiography suggested that all eight cases were single-vessel lesion. All the patients received PCI treatment, and Drug-eluting stent (DES) was used in all cases. Six were treated with one stent, one was treated with two stents and one was treated with three stents. After PCI, aspirin, and clopidogrel (or ticagrelor) were used in all cases. During the follow-up, one developed stent thrombus 2 months later, two developed stent restenosis 1 year later. In conclusion, PCI is an effective method of revascularization in patients with ET; but it may be associated with a higher rate of complications including stent thrombus and restenosis.
特发性血小板增多症(ET)可引起全身血管血栓形成,但累及冠状动脉较为少见。本研究旨在分析经皮冠状动脉介入治疗(PCI)后 ET 患者的特征、治疗及随访期间的预后。回顾性分析 2012 年至 2018 年我院收治的 8 例因冠心病行 PCI 的 ET 患者的基本临床资料,包括临床资料、冠状动脉介入资料、抗血小板及血小板减少药物应用情况、长期随访结果等。男 5 例,女 3 例,中位年龄 67 岁。临床表现为不稳定型心绞痛 4 例,稳定型心绞痛 1 例,ST 段抬高型心肌梗死 2 例,非 ST 段抬高型心肌梗死 1 例。入院时血小板计数平均为 722×10/L,7 例使用羟基脲。冠状动脉造影提示 8 例均为单支血管病变。所有患者均接受 PCI 治疗,均使用药物洗脱支架(DES)。6 例植入 1 枚支架,1 例植入 2 枚支架,1 例植入 3 枚支架。PCI 术后所有患者均使用阿司匹林联合氯吡格雷(或替格瑞洛)。随访期间,1 例患者于术后 2 个月发生支架内血栓,2 例患者于术后 1 年发生支架内再狭窄。综上,PCI 是治疗 ET 患者血运重建的有效方法,但可能会导致更高的并发症发生率,包括支架内血栓形成和再狭窄。