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Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
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Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function

Published on: March 15, 2022

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Primary percutaneous coronary intervention for ST-segment-elevation myocardial infarction in a patient taking

Imdad Ahmed, Stephen J Voyce

    Texas Heart Institute Journal
    |April 16, 2015
    PubMed

    Insights

    This case study presents the first emergency coronary angiography and percutaneous coronary intervention in a ST-elevation myocardial infarction patient on dabigatran for atrial fibrillation. The patient experienced no bleeding complications, suggesting feasibility of these procedures.

    Area of Science:

    • Cardiology
    • Interventional Cardiology
    • Pharmacology

    Background:

    • Optimal management for ST-elevation myocardial infarction (STEMI) patients on chronic oral anticoagulation is unclear.
    • Therapeutic anticoagulation is crucial for conditions like atrial fibrillation but complicates emergency cardiac procedures.

    Observation:

    • A case of STEMI in a patient on dabigatran for atrial fibrillation requiring emergency coronary angiography and primary percutaneous coronary intervention is reported.
    • The patient underwent successful procedures without any bleeding complications.

    Findings:

    • This represents the first reported instance of successful emergency coronary angiography and primary percutaneous coronary intervention in a STEMI patient on dabigatran.
    • The patient's outcome suggests that these interventions are feasible in this high-risk population.

    Implications:

    • This case provides valuable preliminary data for interventional cardiologists managing STEMI patients on oral anticoagulants.
    • Further research is needed to establish evidence-based guidelines for periprocedural anticoagulation management in these patients.

    Keywords:
    Anticoagulants/administration & dosage/adverse effects/therapeutic useclinical protocols/standardsmedication therapy management/standardsmyocardial infarction/therapymyocardial revascularizationpercutaneous coronary interventionrisk assessmentthrombolytic therapytreatment outcome

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