Key result
COVID-19 infection linked to very late stent thrombosis and AMI driven by systemic hypercoagulability.
Why the study?
ACS in COVID-19 secondary to stent thrombosis is an uncommon entity often linked to a hypercoagulable state.
Case Report (n=1)
COVID-19 infection may be associated with very late stent thrombosis due to a hypercoagulable state, which can be successfully managed with balloon angioplasty and GP IIb-IIIa inhibitors.
May prompt vigilance for stent thrombosis in COVID-19; hypothesis-generating and should not yet change practice.
Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2 has varied manifestation with multisystem involvement. Acute coronary syndrome in COVID-19 as a result of stent thrombosis is an uncommon entity and is often due to hypercoagulable state. A 40-year-old male was referred to us with acute onset chest pain. He also reported fever, sore throat and dry cough for six days which mandated testing for COVID-19 which turned out to be positive. He had a prior history of coronary artery disease with a drug eluting stent implanted two years back. An electrocardiogram was suggestive of acute anterior wall myocardial infarction while echocardiogram revealed hypokinesia of left anterior descending (LAD) artery territory. Coronary angiogram revealed non-occlusive thrombus in proximal LAD stent. A Thrombolysis in Myocardial Infarction (TIMI) III flow was restored following balloon angioplasty with a non-compliant balloon and use of glycoprotein (GP) IIb-IIIa receptor antagonist. A diagnosis of very late stent thrombosis subsequent to COVID-19 was made.
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Kunal et al. (2021) conducted a case report in Very late stent thrombosis and COVID-19 (n=1). COVID-19 infection was evaluated on Very late stent thrombosis and acute myocardial infarction. COVID-19 infection was associated with the development of very late stent thrombosis and acute myocardial infarction in a 40-year-old male, likely due to a systemic hypercoagulable state.
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