Key result
In a 73-year-old man with acute myocardial infarction and renal failure who developed heparin-induced thrombocytopenia, treatment with bivalirudin stabilized his condition without new embolic events.
Why the study?
The incidence of heparin-induced thrombocytopenia after PCI in patients with myocardial infarction complicated with renal failure is rarely reported.
Does heparin treatment cause heparin-induced thrombocytopenia in a patient with acute myocardial infarction and renal failure undergoing hemodialysis and PCI?
Case Report (n=1)
No
Does heparin treatment cause heparin-induced thrombocytopenia in a patient with acute myocardial infarction and renal failure undergoing hemodialysis and PCI?
Highlights the importance of close platelet monitoring for heparin-induced thrombocytopenia in patients receiving heparin and antiplatelet therapy during PCI and hemodialysis.
Bivalirudin may stabilize HIT in AMI with renal failure; single case leaves open need for controlled data.
BACKGROUND: Heparin-induced thrombocytopenia (HIT) is a rare complication of heparin therapy, and is characterized by arteriovenous thrombosis and bleeding events. The incidence of HIT after percutaneous coronary intervention (PCI) in patients with myocardial infarction complicated with renal failure is rarely reported. CASE SUMMARY: We report a 73-year-old man with acute myocardial infarction and renal failure who underwent hemodialysis and PCI, and developed a progressive decline in platelets and subcutaneous hemorrhage of both upper limbs after heparin treatment. In addition to a gradual decrease in platelets, the patient's 4T's score was 7, and HIT antibody was positive, confirming the diagnosis of HIT. CONCLUSION: Patients receiving heparin combined with antiplatelet therapy should be monitored closely, especially for their platelet count. In the case of thrombo-cytopenia, HIT should be highly suspected. When the diagnosis of HIT is confirmed, timely individualized treatment should be delivered.
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Wang et al. (2020) conducted a case report in Heparin-induced thrombocytopenia, acute myocardial infarction, chronic renal insufficiency (n=1). Bivalirudin was evaluated on Platelet count recovery and absence of new thromboembolic or bleeding events. In a 73-year-old man with acute myocardial infarction and renal failure who developed heparin-induced thrombocytopenia, treatment with bivalirudin stabilized his condition without new embolic events.
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