One case of death in a patient with coronary heart disease complicated with rheumatoid arthritis after PCI
Shen Tong1, Shen Cheng1, Zhang Yanyan2, Yan Xinzhuo3, Gan Lijun1.
1Department of Cardiology, 2Admission and Patient Service Center, Affiliated Hospital of Jining Medical University, Jining 272029, China; 3First Clinical College, Changsha Medical University, Changsha 410220, China
Abstract：ObjectiveTo explore the mechanism of stent thrombosis after percutaneous coronary intervention (PCI) in a patient with coronary heart disease and rheumatoid arthritis (RA), and to explore the indications and timing of PCI. MethodsThe clinical data of a patient with coronary heart disease complicated with RA who died after PCI in the Department of Cardiology of the Affiliated Hospital of Jining Medical University on March 5, 2021 were selected, and the relevant literature was reviewed. ResultsThe patient had a 30-year history of RA, which was poorly controlled by long-term use of hormone drugs, and the pain worsened in the past 10 days. The patient had a 10-year history of coronary heart disease and underwent PCI. The anti-cyclic citrulline peptide antibody was 85.33U/mL, rheumatoid factor 66.61U/mL, erythrocyte sedimentation rate 42mm/h, C-reactive protein 17.4mg/L, and D-dimer 0.66mg/L. On March 14, 2021, preoperative coronary angiography showed acute stent thrombosis. On March 16, 2021, coronary angiography showed 90% stenosis in the proximal segment of left anterior descending (LAD) and 95% stenosis in the opening of D1 branch. The patient underwent PCI and a stent was implanted in the proximal segment of the LAD. Thirty minutes after the operation, the patient felt severe pain in the precordial area. Emergency coronary angiography showed thrombosis in the LAD stent, and the thrombolysis in myocardial infarction flow grade was 0. After active treatment, the patient died. ConclusionsCoronary heart disease patients with RA in the acute phase are prone to stent thrombosis after PCI. It is necessary to fully evaluate the indications and choose the appropriate time before PCI.
神童 申程 张艳艳 颜欣卓 甘立军. 冠心病合并类风湿关节炎患者PCI术后死亡一例[J]. 中华诊断学电子杂志, 2024, 12(4): 241-244.
Shen Tong1, Shen Cheng1, Zhang Yanyan2, Yan Xinzhuo3, Gan Lijun1. . One case of death in a patient with coronary heart disease complicated with rheumatoid arthritis after PCI. zhzdx, 2024, 12(4): 241-244.
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