Acute ST-segment elevation myocardial infarction as the first manifestation of essential thrombocytosis successfully treated with thrombectomy alone

Khaheshi, Isa; Memaryan, Mehdi; Taherkhani, Maryam; Serati, Alireza; Movahed, Mohammad Reza

doi:10.1007/s12928-015-0347-z

Cited by 4 publications

(7 citation statements)

References 12 publications

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“…JAK2-V617F mutation is present in approximately 50% to 60% of ET cases. It doubles the risk of thrombosis along with hypertension and smoking being substantial risk factors [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

Ischemic Stroke in a Young Man: Unraveling the Domain of Myeloproliferative Disorders

Hamid¹,

Sehbai²,

Tariq³

2021

Cureus

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Ischemic stroke is a rare phenomenon in young adults. A complete workup for hypercoagulable and myeloproliferative disorders is a cornerstone of evaluation. Essential thrombocytosis is a chronic myeloproliferative disorder that primarily involves platelets. It may remain undiagnosed in patients and subsequently present in the form of ischemic stroke. The management of this disorder is complex and often involves cytoreduction therapies. The initiation of these drugs in such patients may lead to unnecessary adverse effects and complications. This case report is an attempt to highlight an underappreciated cause of stroke when assessing young individuals.

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“…JAK2-V617F mutation is present in approximately 50% to 60% of ET cases. It doubles the risk of thrombosis along with hypertension and smoking being substantial risk factors [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

Ischemic Stroke in a Young Man: Unraveling the Domain of Myeloproliferative Disorders

Hamid¹,

Sehbai²,

Tariq³

2021

Cureus

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“…Acute coronary syndrome constitutes a major cause of morbidity and mortality in patients with untreated ET. In a study by Gao et al, it was reported that LAD was the most commonly occluded artery in patients with myocardial infarction (MI) and ET [4-5].…”

Section: Discussionmentioning

confidence: 99%

“…The mutation of JAK2 V617F is present in 50% to 60% of ET cases [5]. This mutation increases the risk of thrombosis by approximately two-fold in patients with ET.…”

Section: Discussionmentioning

confidence: 99%

“…This mutation increases the risk of thrombosis by approximately two-fold in patients with ET. It has been reported that hypertension and smoking are risk factors for the development of thrombosis in these patients [5]. In a study evaluating the factors associated with higher risk of thrombosis in 126 young patients (between the ages of five and 40 years) with ET, it was reported that smoking was the only predictive factor, with the actuarial probability of thrombosis being 72% at 10 years in smokers [6].…”

Section: Discussionmentioning

confidence: 99%

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Acute ST-segment Elevation Myocardial Infarction as the First Manifestation of Essential Thrombocytosis

Sharma¹,

Gupta²,

Patel³

et al. 2019

Cureus

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A 36-year-old female with no significant past medical history presented with sudden onset of crushing substernal chest pain. When the emergency medical services (EMS) arrived, she had a cardiac arrest requiring defibrillation two times in the field prior to arriving at the hospital. In the emergency department (ED), the electrocardiogram (ECG) was significant for ST-elevation that suggested acute anterolateral infarct. Her laboratory evaluation also showed a platelet count of 1095 x 10 3 /ul. Also, her troponin levels were at 0.16 ng/ml at the time of arrival and peaked at 42.8 ng/ml. She immediately underwent a cardiac catheterization which showed 100% occlusion of her left anterior descending (LAD) artery by a thrombus, which was then treated with a thrombectomy and a single drug-eluting stent was placed. Upon further work-up of her thrombocytosis, the patient had a bone marrow biopsy showing megakaryocytic hyperplasia which no evidence of fibrosis. She was tested for Janus kinase 2 (JAK2) mutation which was positive. The patient was diagnosed with essential thrombocytosis (ET) and was started on cytoreduction therapy with hydroxyurea. Her platelet counts responded appropriately and dropped to less than 500 x 10 3 at the time of discharge.

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“…With regard to the treatment of ACS in the setting of ET, thrombus aspiration [ 24 , 30 ], intracoronary thrombolysis [ 24 ], balloon angioplasty [ 30 ], stent placement [ 42 , 43 ], coronary bypass grafting (CABG) [ 44 ] and systemic fibrinolytic/thrombolytic treatment [ 10 ] have all been described. The optimal choice of intervention and the timing thereof should be on an individual basis, taking the presence of spasm, thrombus, atherosclerosis, ongoing ischaemia and concurrent platelet counts into account.…”

Section: Treatment Of the Cardiovascular Complications Of Etmentioning

confidence: 99%

Essential thrombocytosis: diagnosis, differential diagnosis, complications and treatment considerations of relevance for a cardiologist

et al. 2023

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Essential thrombocytosis (ET) is a rare haematological malignancy, with an incidence rate of 1.5–2.5/100,000 per year. For many patients with ET the first manifestation of their underlying disease is a thrombotic or haemorrhagic complication. A recent retrospective study revealed an incidence rate of at least 2.1% in people under 40 years presenting with an acute coronary syndrome, although the diagnosis was initially missed in all cases. Thus, cardiologists face a much higher than average incidence rate of ET in their daily practice, but seem insufficiently aware of the disease. The current review summarises symptoms, (differential) diagnosis, complications and treatment considerations of ET of relevance for a cardiologist. Typical symptoms, besides thrombosis and haemorrhage, include erythromelalgia and aquagenic pruritus, while platelets > 450 × 109/l are a diagnostic for ET once other myeloproliferative neoplasms, secondary and spurious thrombocytosis have been excluded. With regard to treatment, timing of revascularisation depends on the presence of ischaemia and concurrent platelet counts. In the presence of ischaemia, revascularisation should not be delayed and adequate platelet counts can be achieved by platelet apheresis. In the absence of ischaemia, revascularisation can be delayed until adequate platelet counts have been achieved by cytoreductive therapies. Cardiologists should be aware of/screen for possible ET.

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Acute ST-segment elevation myocardial infarction as the first manifestation of essential thrombocytosis successfully treated with thrombectomy alone

Cited by 4 publications

References 12 publications

Ischemic Stroke in a Young Man: Unraveling the Domain of Myeloproliferative Disorders

Ischemic Stroke in a Young Man: Unraveling the Domain of Myeloproliferative Disorders

Acute ST-segment Elevation Myocardial Infarction as the First Manifestation of Essential Thrombocytosis

Essential thrombocytosis: diagnosis, differential diagnosis, complications and treatment considerations of relevance for a cardiologist

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