ST-Segment Elevation Myocardial Infarction as a Result of Coronary Artery Ectasia-Related Intracoronary Thrombus in a Patient with Liver Cirrhosis
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초록
Coronary artery ectasia (CAE) is a rare condition defined as the dilatation of coronary artery to at least 1.5 times larger than the normal adjacent coronary artery. Clinical manifestations of CAE vary, ranging from asymptomatic to ST-segment elevation myocardial infarction (STEMI). Because of its rarity and clinical diversity, the best treatment strategy and prognosis for CAE remain unclear. We describe a case of STEMI caused by intracoronary thrombus formation within an ectatic area in a patient with liver cirrhosis (LC). The patient was successfully managed by thrombus aspiration only, without balloon angioplasty or stent implantation, and maintained by dual antiplatelet therapy with aspirin and ticagrelor, a potent new P2Y12 inhibitor.
Abstract
Coronary artery ectasia (CAE) is a rare condition defined as the dilatation of coronary artery to at least 1.5 times larger than the normal adjacent coronary artery. Clinical manifestations of CAE vary, ranging from asymptomatic to ST-segment elevation myocardial infarction (STEMI). Because of its rarity and clinical diversity, the best treatment strategy and prognosis for CAE remain unclear. We describe a case of STEMI caused by intracoronary thrombus formation within an ectatic area in a patient with liver cirrhosis (LC). The patient was successfully managed by thrombus aspiration only, without balloon angioplasty or stent implantation, and maintained by dual antiplatelet therapy with aspirin and ticagrelor, a potent new P2Y12 inhibitor.
참고문헌 (20)
- Swaye PS, "Aneurysmal coronary artery disease", Circulation, 67, pp.134~138 (1983)
- Manginas A, "Coronary artery ectasias:imaging, functional assessment and clinical implications", Eur Heart J, 27, pp.1026~1031 (2006)
- Demopoulos VP, "The natural history of aneurysmal coronary artery disease", Heart, 78, pp.136~141 (1997)
- Yetkin E, "Novel insights into an old controversy: is coronary artery ectasia a variant of coronary atherosclerosis?", Clin Res Cardiol, 96, pp.331~339 (2007)
- Otsubo R, "Influence of chronic liver disease on coronary atherosclerosis vulnerability features", Int J Cardiol, 109, pp.387~391 (2006)
- Movahed MR, "Trends in the age adjusted mortality from acute ST segment elevation myocardial infarction in the United States (1988-2004) based on race, gender, infarct location and comorbidities", Am J Cardiol, 104, pp.1030~1034 (2009)
- al-Harthi SS, "Aneurysmal dilatation of the coronary arteries: diagnostic patterns and clinical significance", Int J Cardiol, 30, pp.191~194 (1991)
- Printz BF, "Noncoronary cardiac abnormalities are associated with coronary artery dilation and with laboratory inflammatory markers in acute Kawasaki disease", J Am Coll Cardiol, 57, pp.86~92 (2011)
- Dahhan A, "Coronary artery ectasia in atherosclerotic coronary artery disease, inflammatory disorders, and sickle cell disease", Cardiovasc Ther, 33, pp.79~88 (2015)
- Pinar Bermúdez E, "Coronary ectasia: prevalence, and clinical and angiographic characteristics", Rev Esp Cardiol, 56, pp.473~479 (2003)
- Mendelsohn ME, "The protective effects of estrogen on the cardiovascular system", N Engl J Med, 340, pp.1801~1811 (1999)
- Castilla A, "Transforming growth factors beta 1 and alpha in chronic liver disease. Effects of interferon alfa therapy", N Engl J Med, 324, pp.933~940 (1991)
- Arjal R, "International normalized ratio of prothrombin time in the model for end-stage liver disease score: an unreliable measure", Clin Liver Dis, 13, pp.67~71 (2009)
- Krüger D, "Exercise-induced myocardial ischemia in isolated coronary artery ectasias and aneurysms (“dilated coronopathy”)", J Am Coll Cardiol, 34, pp.1461~1470 (1999)
- Roffi M, "2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent STsegment elevation: Task Force for the Management of Acute Coronary Syndromes in Patients Presenting without Persistent ST-Segment Elevation of the European Society of Cardiology (ESC)", Eur Heart J (2015)
- Tsochatzis EA, "New therapeutic paradigm for patients with cirrhosis", Hepatology, 56, pp.1983~1992 (2012)
- Ge PS, "The changing role of beta-blocker therapy in patients with cirrhosis", J Hepatol, 60, pp.643~653 (2014)
- Vijayanagar R, "Surgical treatment of coronary aneurysms with and without rupture", J Thorac Cardiovasc Surg, 107, pp.1532~1535 (1994)
- Suk-Kyu Oh, "Two Different Successful Angioplasty Methods in Patients with Stenotic Coronary Artery Ectasia", 전남의대학술지, 48(3), pp.185~189 (2012), 의과학연구소
- Echavarría-Pinto M, "Safety and efficacy of intense antithrombotic treatment and percutaneous coronary intervention deferral in patients with large intracoronary thrombus", Am J Cardiol, 111, pp.1745~1750 (2013)