In a young woman with STEMI, classic plaque rupture and a large thrombus in the LAD resolved with dual antiplatelet therapy without the need for stenting.
Does aggressive antithrombotic therapy without stenting resolve thrombus in a young woman with STEMI due to plaque rupture/erosion?
Intracoronary imaging (OCT) can identify plaque erosion/rupture with thrombus in young STEMI patients, allowing for successful conservative management with aggressive antithrombotic therapy without stenting.
Absolute Event Rate: 0% vs 0%
Acute myocardial infarction with ST elevation (STEMI) is a disease of the elderly, rarely of people younger than 40 years, predominantly men with comorbidities. The incidence of STEMI infarction in the general population in women younger than 40 years is very low. This paper presents the case of a young woman who was admitted with a diagnosis of STEMI infarction, which was understood as SCAD after coronary angiography. Repeated invasive diagnostics with intracoronary imaging determined that it was a classic infarction with plaque rupture/erosion and a large intraluminal thrombotic mass that partially embolized with occlusion of the apical part of the anterior descending artery (LAD). She was treated during hospitalization with dual antiplatelet therapy (DAPT) using a potent P2Y12 inhibitor and low molecular weight heparin, high dose of statins. Control coronary angiography revealed insignificant narrowing of the distal part of the main trunk of the left coronary artery (LM) and the proximal segment of the LAD with almost complete resolution of the thrombus. DAPT treatment was continued without stent implantation.
Živanović et al. (Wed,) reported a other. In a young woman with STEMI, classic plaque rupture and a large thrombus in the LAD resolved with dual antiplatelet therapy without the need for stenting.