Non-ST-Elevation Myocardial Infarction as the Initial Manifestation of Calreticulin-Positive Essential

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Jared B Hinton1, Jalal S Jwayyed1, Sonum Jagetia1

  • 1Department of Medicine, Northeast Ohio Medical University, Rootstown, OH 44272, USA.

Journal of Cardiovascular Development and Disease
|April 25, 2025
PubMed

Essential thrombocythemia (ET) is a rare myeloproliferative neoplasm characterized by excessive platelet production and a predisposition to thrombotic or hemorrhagic complications. We report a case of a 62-year-old male with no conventional cardiovascular risk factors who presented with a non-ST-segment elevation myocardial infarction (NSTEMI). Initial coronary angiography showed isolated proximal LAD stenosis. Laboratory tests revealed marked thrombocytosis (>1,000,000/μL) and a CALR mutation, confirming a diagnosis of ET. The patient was treated with percutaneous coronary intervention (PCI), dual antiplatelet therapy, and cytoreductive therapy with hydroxyurea, leading to a favorable outcome. This case illustrates how ET, particularly CALR-mutated subtypes, can manifest as acute coronary syndrome in the absence of atherosclerosis and underscores the need to consider hematologic malignancies in atypical presentations of myocardial infarction.

Keywords:
CALR mutationacute coronary syndrome (ACS)essential thrombocythemia (ET)myeloproliferative neoplasm (MPN)non-ST-elevation myocardial infarction (NSTEMI)thrombocytosisthrombotic complications

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