Key result
COVID-19 linked to acute DES restenosis in STEMI driven by hypercoagulability and heparin resistance.
Why the study?
SARS-CoV-2 can induce a hypercoagulable state that complicates the management of patients presenting with acute MI.
Case Report (n=1)
Highlights the risk of hypercoagulability and potential heparin resistance leading to acute stent thrombosis in COVID-19 patients undergoing PCI for STEMI.
Raises caution for acute stent thrombosis in COVID-19 STEMI PCI; hypothesis-generating for tailored anticoagulation and requires confirmation.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can cause a hypercoagulable state that can complicate the management of patients presenting with acute myocardial infarction (MI). We present the case of a patient with coronavirus disease 2019 (COVID-19) with ST elevation MI who was treated with percutaneous coronary intervention and stenting to the left circumflex artery. He was treated appropriately with anticoagulation with appropriate activated clotting time. However, the coronary angiogram course was complicated with heavy thrombosis that involved the left circumflex artery and the left anterior descending artery. Physicians are urged to suspect heparin resistance in COVID-19 patients, particularly if those patients have venous thromboembolism or acute coronary syndrome while taking heparin.
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Zaher et al. (2020) conducted a case report in COVID-19 with ST elevation myocardial infarction (n=1). Percutaneous coronary intervention with drug-eluting stent and heparin was evaluated on Acute stent restenosis. A 51-year-old man with COVID-19 and STEMI experienced acute stent restenosis within minutes of drug-eluting stent placement, likely due to COVID-19-induced hypercoagulability and heparin resistance.
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