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Recurrent Cardiovascular Events Despite Antiplatelet Therapy in a Patient with Polycythemia Vera and Accelerated Platelet Turnover.
| Content Provider | Europe PMC |
|---|---|
| Author | Pedersen, Oliver Heidmann Larsen, Mads Lamm Kristensen, Steen Dalby Hvas, Anne-Mette Grove, Erik Lerkevang |
| Copyright Year | 2017 |
| Abstract | Patient: Male, 58Final Diagnosis: STEMISymptoms: Angina pectorisMedication:—Clinical Procedure: —Specialty: HematologyObjective:Unusual clinical courseBackground:Clopidogrel is commonly used in the prevention and treatment of cardiovascular events. However, despite clopidogrel treatment, some patients experience recurrent ischemic events.Case Report:We present the case of a 58-year-old man with polycythemia vera and concomitant thrombocytosis who suffered 6 episodes of cerebral infarctions and 1 myocardial infarction, despite treatment with clopidogrel. Following his last ischemic event, the antiplatelet therapy was intensified from initially clopidogrel monotherapy to dual antiplatelet therapy with aspirin 75 mg once daily and ticagrelor 90 mg twice daily. Since then, no cardiovascular event has been reported.Conclusions:This case report illustrates that insufficient platelet inhibition with clopidogrel monotherapy in a patient with thrombocytosis may be associated with recurrent arterial thrombosis. The exact reasons for the insufficient platelet inhibition are not known, but a plausible explanation may be an accelerated platelet turnover reflected by an increased number of immature platelets in this patient.The findings in this case indicate that further studies are warranted to determine the role of immature platelets as markers of accelerated platelet turnover and poor response to antiplatelet treatment. |
| Volume Number | 18 |
| PubMed Central reference number | PMC5590514 |
| PubMed reference number | 28860447 |
| Journal | The American Journal of Case Reports [Am J Case Rep] |
| e-ISSN | 19415923 |
| DOI | 10.12659/AJCR.904148 |
| Language | English |
| Publisher | International Scientific Literature, Inc. |
| Publisher Date | 2017-09-01 |
| Access Restriction | Open |
| Rights License | This work is licensed under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) © Am J Case Rep, 2017 |
| Subject Keyword | Blood Platelets Platelet Aggregation Platelet Aggregation Inhibitors Platelet Count Purinergic P2Y Receptor Antagonists Thrombocytosis |
| Content Type | Text |
| Resource Type | Article |
| Subject | Medicine |
