Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0151814 (coronary occlusion)
 3,687 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Patients with antiphospholipid syndrome (APS) are prone to excessive postoperative morbidity and mortality after cardiovascular surgery because of its thromboembolic derangements. We present a case of coronary artery bypass grafting (CABG) in a patient with primary APS. He suffered from repetitive coronary occlusion after percutaneous transluminal coronary angioplasty (PTCA). Since his lupus anticoagulant level was found to be 217 s (normal, <50 s), he was diagnosed as the primary APS. He received steroid pulsation therapy with 1000 mg of prednisolone, double-filtration plasmapheresis (DFPP) and 50 mg of cyclophosphamide to attenuate the antibody activity. Four months after the last PTCA, he experienced chest pain and approximately 90% of stenosis in the left anterior descending (LAD) lesion was apparent, although the titer for the lupus anticoagulant was reduced to the normal range. He had drug allergy to ticlopidine hydrochloride and aspirin. Taken together, his disease was found to be resistant to these medical treatments, and surgical treatment was considered. Since cardiopulmonary bypass is known to exaggerate its coagulatory and fibrinolytic complications, off-pump CABG (OPCAB) was feasible in this case. The left internal thoracic artery (ITA) was anastomosed to the LAD using the off-pump technique. The procedure was successful, and the postoperative course for 3 years has been satisfactory without any cardiovascular complaints.
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PMID:Off-pump coronary artery bypass in a patient with the antiphospholipid syndrome. 1575 83

Antiphospholipid syndrome (APS) is an autoimmune coagulation disorder that manifests clinically as venous and arterial thrombosis, and may affect any tissue or organ. Coronary artery involvement, however, is very rare. Case reports in the literature describing patients with coronary acute syndrome and APS treated with coronary angioplasty show conflicting results. We report an adult male patient with APS who presented with an acute myocardial infarction. Given the high risk of thrombosis in these patients, he was treated percutaneously with thrombectomy and abciximab. We review the few cases of coronary angioplasty in patients with APS reported to date. To our knowledge, this is the first case in which acute myocardial infarction due to thrombotic coronary occlusion was treated with thrombectomy and abciximab without stenting the artery.
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PMID:Antiphospholipid syndrome and acute myocardial infarction: treatment with thrombectomy and abciximab. 2512 41

Antiphospholipid syndrome (APS), one of the most common states of acquired hypercoagulability, is diagnosed by the persistent presence of antiphospholipid antibodies and recurrent episodes of vascular thrombosis. We present the case of a 39-year-old man late-presenting for cardiac rehabilitation treatment after primary percutaneous coronary intervention (PCI) performed for anteroseptal myocardial infarction. He was a nonsmoker, with no prior personal history of other cardiovascular diseases (CVD) or cardiometabolic syndrome. The 60% thrombotic occlusion of the left anterior descending artery (LAD) leading to the acute cardiac event was the only abnormality that was found. The only etiological explanation was the late measurement and the positive tests for antiphospholipid antibodies. In young patients with no history of thrombotic disorder, such as cancer, cardiovascular or metabolic diseases, the unexpected onset of myocardial infarction by thrombotic coronary occlusion can be attributed to silent, undiagnosed autoimmune condition.
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PMID:Unexpected Coronary Thrombosis Induced By Antiphospholipid Syndrome (Hughes Syndrome): Case Report. 3014 9