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Long-term successful coronary artery angioplasty in polycythemia vera
M Guazzi1, G Esposito, A Loaldi
1Istituto di Cardiologia dell'Universita' degli Studi, Consiglio Nazionale delle Ricerche, Fondazione Monzino, I.R.C.C.S., Milan, Italy.
Insights
Percutaneous coronary angioplasty (PTCA) showed long-term success in a patient with Polycythemia Vera, a condition with high thrombosis risk. This case suggests Polycythemia Vera may not preclude successful coronary PTCA.
Area of Science:
- Cardiology
- Hematology
Background:
- Polycythemia Vera (PV) is a myeloproliferative neoplasm associated with an increased risk of thrombotic events.
- Patients with PV often present with cardiovascular complications, including coronary artery disease.
Observation:
- A 65-year-old male with PV and severe angina underwent successful percutaneous coronary angioplasty (PTCA) of the right coronary artery.
- The patient remained symptom-free for 12 months on antiplatelet, calcium antagonist, and nitrate therapy.
Findings:
- Repeat angiography after 12 months showed good patency of the treated artery, with new stenosis in another vessel.
- This represents the first reported case of long-term PTCA success in a patient with Polycythemia Vera.
Implications:
- Coronary PTCA may be a viable option for select patients with Polycythemia Vera, despite the inherent thrombotic risk.
- Further research is needed to determine the role of medical management in long-term outcomes and to assess the generalizability of these findings.
Abstract:
In a 65-year-old man with Polycythemia Vera, invalidating angina pectoris was associated with severe narrowing of the right coronary artery. After percutaneous coronary angioplasty (PTCA) the patient became symptom free and remained so for 12 months, while receiving an antiplatelet agent, a calcium antagonist and nitrate. Coronary angiography repeated after a year, because of reappearance of angina, documented good patency of the treated artery and some progression of a narrowing involving another coronary vessel. This is the first reported case of long-term success of PTCA in Polycythemia Vera, a disease exposed to a high risk of thrombosis and, possibly, of restenosis. It is undefined whether medical treatment contributed to the anatomical and clinical results. As far as a single case can say, Polycythemia Vera might not represent a prohibitive background for coronary PTCA.