Key result
Percutaneous coronary intervention with a drug-eluting stent in a 68-year-old man on chronic warfarin for atrial fibrillation presented a clinical dilemma regarding life-threatening GI bleeding.
Why the study?
How should life-threatening gastrointestinal bleeding be managed early after coronary drug-eluting stent implantation in a patient on chronic oral anticoagulation?
Case Report (n=1)
How should life-threatening gastrointestinal bleeding be managed early after coronary drug-eluting stent implantation in a patient on chronic oral anticoagulation?
This case highlights the complex clinical challenge of managing life-threatening gastrointestinal bleeding in a patient requiring dual antiplatelet therapy early after drug-eluting stent implantation alongside chronic anticoagulation for atrial fibrillation.
Life-threatening post-DES GI bleeding on OAC remains a clinical challenge; leaves open optimal antithrombotic strategies for prospective study.
BACKGROUND: A 68-year-old man was referred for stable angina pectoris and a large apical perfusion defect on stress myocardial scintigraphy. Medical history included chronic oral anticoagulation with warfarin due to longstanding atrial fibrillation, type 2 diabetes mellitus, hypertension, and dyslipidaemia. INVESTIGATION: Coronary angiography. DIAGNOSIS: Severe stenosis of the mid left anterior descending coronary artery. TREATMENT: Percutaneous coronary intervention with implantation of drug-eluting stent.
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Fabbiocchi et al. (2013) conducted a case report in Severe stenosis of the mid left anterior descending coronary artery and life-threatening gastrointestinal bleeding (n=1). Percutaneous coronary intervention with implantation of drug-eluting stent was evaluated. Percutaneous coronary intervention with a drug-eluting stent in a 68-year-old man on chronic warfarin for atrial fibrillation presented a clinical dilemma regarding life-threatening GI bleeding.
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