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Stent thrombosis during COVID-19 pandemic: A case series

Mohammad Montaseri1, Reza Golchin Vafa2, Armin Attar1

  • 1Cardiology Ward Shiraz University of Medical Sciences Shiraz Iran.

Clinical Case Reports
|May 23, 2022
PubMed

Insights

COVID-19 and vaccination can increase stent thrombosis risk due to hypercoagulable states. Standard guidelines are needed to prevent these serious cardiovascular events.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Vascular Medicine

Background:

  • The COVID-19 pandemic has been linked to various cardiovascular complications beyond respiratory issues.
  • Patients with COVID-19 exhibit a higher incidence of thrombotic events compared to non-COVID-19 individuals.
  • COVID-19 vaccination has also been associated with an increased risk of thrombotic events.

Observation:

  • Three case studies illustrate severe stent thrombosis and in-stent restenosis (ISR) in patients presenting with ST-elevation myocardial infarction (STEMI).
  • One patient developed ventricular fibrillation and required defibrillator shocks following stent thrombosis.
  • Two patients had a history of prior angioplasty, and one presented shortly after receiving the Oxford/AstraZeneca COVID-19 vaccine.

Findings:

  • All presented cases demonstrated severe thrombotic in-stent restenosis (ISR) in coronary arteries, including the left anterior descending (LAD) and right coronary artery (RCA).
  • These events occurred in patients with COVID-19 or following COVID-19 vaccination, suggesting a link to a hypercoagulable state.
  • Successful percutaneous coronary intervention (PCI) was performed in the cases where it was indicated.

Implications:

  • The findings highlight the critical need for heightened awareness of stent thrombosis in patients with COVID-19 and post-vaccination.
  • Development of standardized guidelines for the prevention and management of stent thrombosis in this context is crucial.
  • Further research is warranted to elucidate the mechanisms underlying vaccine- or infection-induced hypercoagulability and its impact on cardiovascular implants.

Keywords:
COVID‐19cardiovascular diseasein‐stent restenosis

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