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Published on: February 28, 2012
Triple Therapy When Thrombotic Risk Exceeds Bleeding Risk: Polycythemia Vera in a Patient With Atrial Fibrillation
Elif Aksoy1,2, Isaac Akkad1, Giorgio Medranda1
1Cardiology Department, NYU Langone Long Island Hospital, 259 1st St, Mineola, NY 11501, USA.
Abstract:
Currently, there is no approved guideline regarding management of patients with polycythemia vera (PCV) undergoing percutaneous coronary intervention (PCI) given the low prevalence. Standard maintenance therapy may be inadequate in cases where patients' response to standard treatment show heterogeneity. Approximately 5-10% of patients undergoing PCI are reported to have an additional indication for triple antiplatelet therapy consisting of aspirin, an adenosine diphosphate (ADP)-receptor antagonist and oral anticoagulant. However, considering the higher bleeding risk that arises with triple antiplatelet therapy, physicians act reluctantly in prescribing the regimen. Here, we present a case of subacute stent thrombosis in a patient with PCV prompting the consideration of triple antiplatelet therapy given increased thrombotic risk.
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