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A Review of Systemic Hematological Manifestations and Stent Thrombosis

Rachael Biggart1, Claire Davies2, Nikhil Joshi3

  • 1From the Bristol Haematology & Oncology Centre, University Hospitals Bristol NHS Foundation Trust, Bristol, England.

Cardiology in Review
|February 24, 2023
PubMed

Insights

Stent thrombosis (ST) may signal an undiagnosed hematological condition. Early specialist testing for unexplained ST is crucial for timely, condition-specific treatment and improved patient outcomes.

Area of Science:

  • Cardiology and Hematology
  • Thrombosis Research

Background:

  • Stent thrombosis (ST) is a serious complication of percutaneous coronary intervention (PCI), associated with high morbidity and mortality.
  • Identifying non-procedural predictors of ST is challenging due to its rarity.
  • Case reports suggest associations between ST and various hematological conditions, both benign and malignant.

Purpose of the Study:

  • To review the literature on stent thrombosis in acquired thrombophilias.
  • To highlight the importance of considering hematological conditions in unexplained ST.
  • To discuss the management complexities at the intersection of cardiology and hematology.

Main Methods:

  • Literature review of stent thrombosis in acquired thrombophilias.
  • Case presentation of ST in paroxysmal nocturnal hemoglobinuria (PNH).
  • Discussion of inherited thrombophilias and testing pitfalls.

Main Results:

  • ST can be an early indicator of undiagnosed hematological disorders like PNH, myeloproliferative disorders (MPNs), antiphospholipid syndrome, hematological malignancies, and heparin-induced thrombocytopenia (HIT).
  • Variability exists in clinical practice for managing ST in these complex cases.
  • Multidisciplinary collaboration between cardiologists and hematologists is essential.

Conclusions:

  • Unexplained stent thrombosis warrants consideration for specialist hematological evaluation.
  • Prompt diagnosis and condition-specific treatment can improve outcomes for patients with ST and underlying hematological conditions.
  • Integrated cardiac-hematology care is vital for optimizing ST management.

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