Could the Novel Oral Anticoagulants Be Used for Coronary Artery Aneurysm?

Yan, Qingzhi; Ning, Libing; J, Yu; Yang, Wencong; Yuan, Qinghua; Du, Zhimin

doi:10.1155/2020/5073814

Cited by 12 publications

(15 citation statements)

References 17 publications

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“…Clinical management of chronic anticoagulation treatment should carefully assess the ischemic risk and haemorrhagic danger of each patient individually. Contemporary literature supports the notion of DOAC's safe profile in the prevention of systemic embolism, even in cases with concomitant LV thrombus [34] in the present case the decision for chronic treatment with a DOAC was amenable to existent literature data displaying antithrombotic management in patients with systematic/arterial thromboembolic events [30][31][32][33]. Regarding cancer patients, the use of DOAC's has been described mainly in the context of deep vein thrombosis and pulmonary embolism [35].…”

Section: Discussionsupporting

confidence: 68%

“…Antithrombotic treatment of patients with blood malignancies and arterial thrombosis can be challenging in daily clinical practice, while few reports in literature describe similar cases [30][31][32][33]. Clinical management of chronic anticoagulation treatment should carefully assess the ischemic risk and haemorrhagic danger of each patient individually.…”

Section: Discussionmentioning

confidence: 99%

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Cardiac amyloidosis presenting with coronary artery embolization

Papageorgiou

Tsagalou

Baraboutis

et al. 2021

Rev. Cardiovasc. Med.

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Amyloid light-chain (AL) amyloidosis is a multisystemic disease. Among its clinical manifestations, vein and arterial thromboembolic events are included. We report the unusual case of a 57-year-old female patient with AL amyloidosis presenting with an ST segment elevation myocardial infarction due to coronary artery embolization (CE). The patient reported a history of exertional dyspnoea along with episodes of haemoptysis for the last few months. Her coronary angiography demonstrated embolization of the distal segment of the left anterior descending artery. The main findings of her cardiac ultrasound included concentric left ventricular hypertrophy, mildly impaired left ventricular systolic function, left atrium enlargement and a restrictive-like filling pattern, while her chest computed tomography (CT) demonstrated bilateral pleural effusions. Cardiac magnetic resonance imaging that was performed afterwards, indicated areas of microvascular infarction, a small apex infarct and findings compatible with possible amyloidosis, a diagnosis that was confirmed later by fat tissue biopsy. Patient was referred for an oncology consultation, started therapy with direct oral anticoagulants, angiotensin converting enzyme inhibitor, statins and anti-plasma cell therapy. She has been improving since then and has been free of cardiovascular events for a follow-up period of 12 months. Cardiologists ought to be aware of amyloidosis as a rare but possible cause of coronary embolization, while close collaboration with oncologists is required for the establishment of the correct diagnosis.

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Section: Discussionsupporting

confidence: 68%

Section: Discussionmentioning

confidence: 99%

Cardiac amyloidosis presenting with coronary artery embolization

Papageorgiou

Tsagalou

Baraboutis

et al. 2021

Rev. Cardiovasc. Med.

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“…However, case reports and small reviews have suggested that anticoagulation (with a direct oral anticoagulant or warfarin) may be acceptable in certain clinical scenarios, for example, when aneurysmal disease has resulted in thrombosis or embolization. 7 However, in the absence of high-risk features, some experts recommend antiplatelet therapy for 1 year after intervention or indefinitely if observation is chosen as the preferred regimen for medium-to-large fistulas. 8 Therefore, with this patient, we recommended dual antiplatelet therapy for 1 year following his coil embolization.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous management strategies for STEMI with coexisting aneurysmal coronary- to-pulmonary artery fistula: a case report

Rothstein

Iribarne

Powell

et al. 2021

European Heart Journal - Case Reports

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Background Coexistence of coronary artery fistulas and atherosclerotic coronary artery disease (CAD) is rare. Case summary We present a unique case of a patient initially presenting with an anterior ST-elevation myocardial infarction, subsequently found to have two-vessel CAD and an aneurysmal left coronary-to-right pulmonary artery fistula. Discussion After discussion with the patient and a multidisciplinary discussion with the heart team, consisting of cardiovascular surgery, interventional cardiology, and vascular surgery, a percutaneous approach was chosen. He underwent successful multivessel percutaneous coronary intervention followed by fistula embolization.

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“…Tras el diagnóstico, se realizó seguimiento con terapia antiplaquetaria simple (TAPS) con aspirina, al cual se le propuso agregar un nuevo anticoagulante oral (NACO), como rivaroxaban, por negación del paciente a usar Warfarina. Se realizó un seguimiento por 6 meses, sin recurrencia del SCA ni dolor pectoral (Yan et al 2020).…”

Section: Pacientesunclassified

Antiagregantes y anticoagulantes en el manejo de ectasia coronaria con flujo lento, una revisión de reportes de caso

Arcos¹

2020

REMCB

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La ectasia coronaria es una dilatación profusa de todo el segmento arterial. Aún no se ha determinado la terapia más adecuada para el proceso trombogénico que acompaña a la ectasia coronaria, por lo que el objetivo de este estudio es establecer si las terapias: antitrombótica doble (TAPS+ACO), triple (TAPD+ACO) o solo con anticoagulante oral (ACO) son útiles para prevenir la recidiva de los síntomas. Se realizó una búsqueda de reportes de casos sobre ectasia coronaria y manejo con anticoagulantes y/o antiagregantes para la prevención de recidivas, publicados desde 1997 hasta mayo de 2020. Se incluyeron 11 reportes. Cinco pacientes recibieron terapia antitrombótica triple (TAPD+ACO), tres pacientes recibieron terapia antitrombótica doble (TAPS+ACO) y tres pacientes recibieron terapia solo con anticoagulante oral (ACO). Ninguno tuvo recurrencias en el periodo de seguimiento. Tanto la terapia solo con ACO, como la terapia antitrombótica doble (ACO + TAP) y triple (ACO + TAPD) mostraron beneficio al prevenir las recurrencias de síndrome coronario agudo (SCA) tras el seguimiento como mínimo de 3 meses. La terapia antitrombótica triple parece ser más eficaz que el uso de TAPD de manera aislada. El uso de nuevos anticoagulantes orales (NACO) podría tener mayor beneficio sobre el uso de los tradicionales. Sin embargo, se requieren más estudios al respecto.

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Could the Novel Oral Anticoagulants Be Used for Coronary Artery Aneurysm?

Cited by 12 publications

References 17 publications

Cardiac amyloidosis presenting with coronary artery embolization

Cardiac amyloidosis presenting with coronary artery embolization

Percutaneous management strategies for STEMI with coexisting aneurysmal coronary- to-pulmonary artery fistula: a case report

Antiagregantes y anticoagulantes en el manejo de ectasia coronaria con flujo lento, una revisión de reportes de caso

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