Key result
Extended rivaroxaban with DAPT successfully resolves high thrombus burden in COVID-19 STEMI.
Why the study?
Cardiac manifestations of COVID-19 include myocardial infarction with a prothrombotic state as a major underlying mechanism, requiring evaluation of anticoagulation strategies.
Case Report (n=1)
No
May guide antithrombotic decisions in COVID-19 STEMI; hypothesis-generating and requires prospective validation.
Cardiac manifestations of COVID-19 include myocarditis, demand ischemia, myocardial infarction and arrhythmias with prothrombotic state being a major underlying pathogenetic mechanism. In this report we present a case of a 57-year-old, otherwise healthy, woman who presented with chest pain and nausea and was found to have an inferior wall ST-elevation myocardial infarction (STEMI) in the setting of an active COVID-19 infection. Angiography revealed tortuous coronary arteries with a 100% right coronary artery occlusion with high thrombus burden and normal left coronary system. In light of the available literature regarding the pro-thrombotic effects of this novel corona virus, we continued full dose anticoagulation with Enoxaparin after the cardiac catheterization and transitioned to rivaroxaban and we also continued the patient on dual antiplatelet therapy prior to discharge.
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Al‐Sadawi et al. (2020) conducted a case report in STEMI and COVID-19 (n=1). PCI, Enoxaparin, Rivaroxaban, and DAPT was evaluated. A 57-year-old woman with COVID-19 and an inferior STEMI with high thrombus burden was successfully treated with PCI, dual antiplatelet therapy, and extended anticoagulation with rivaroxaban.
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