Key result
Medical therapy resolves multivessel coronary thrombosis at 3 months in methamphetamine-associated STEMI.
Why the study?
Crystal methamphetamine abuse is an important cause of multivessel coronary thrombosis and raises doubts about optimal therapeutic options.
Case Report (n=1)
No
Medical therapy with antiplatelets and anticoagulants successfully resolved simultaneous multivessel coronary thrombosis in a crystal methamphetamine abuser, suggesting a viable alternative to PCI when TIMI flow is preserved.
Methamphetamine abuse warrants consideration in young STEMI patients; leaves open optimal management of associated multivessel thrombosis.
This case report underscores that crystal methamphetamine abuse is an important cause of multivessel coronary thrombosis and raises doubts about the therapeutic options. The patient was a 34-year-old smoker and crystal methamphetamine abuser with no significant medical history, who presented with retrosternal chest pain associated with cold sweats. Twelve-lead electrocardiogram revealed diffuse ST-segment elevation in I, II, AVL, AVF, and V 2-6 leads. He underwent urgent coronary angiography and it showed Thrombolysis in Myocardial Infarction (TIMI) grade 3 flow in coronary arteries and presence of a thrombus in the left anterior descending artery (LAD) and the right coronary artery (RCA). The patient underwent medical therapy with antiplatelet agents and anticoagulants. Repeat coronary angiography after three months of dual therapy with warfarin and aspirin did not show any thrombus or any significant lesion in the RCA and the LAD having TIMI grade 3 flow.
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Khaheshi et al. (2015) conducted a case report in Simultaneous thrombosis of the left anterior descending artery and right coronary artery (Acute STEMI) (n=1). Medical therapy (antiplatelets and anticoagulants) was evaluated on Resolution of coronary thrombus on repeat angiography. Medical therapy with antiplatelet agents and anticoagulants successfully resolved simultaneous thrombosis of the left anterior descending and right coronary arteries in a 34-year-old crystal methamphetamine abuser after three months.
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