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Case Report

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Korean J Hematol 2010; 45(2):

Published online June 30, 2010

https://doi.org/10.5045/kjh.2010.45.2.136

© The Korean Society of Hematology

Development of acute myocardial infarction in a young female patient with essential thrombocythemia treated with anagrelide: a case report

Young-Hyo Lim1, Young Yiul Lee2*, Jae Hoon Kim1, Jinho Shin1, Jae Ung Lee1, Kyung-Soo Kim1, Soon-Kil Kim1, Jeong Hyun Kim1, and Heon Kil Lim1

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1Division of Cardiology, Department of Internal Medicine, College of Medicine, Hanyang University, Seoul, Korea.

2Division of Hematology/Oncology, Department of Internal Medicine, College of Medicine, Hanyang University, Seoul, Korea.

Correspondence to : Correspondence to Young Yiul Lee, M.D., Ph.D. Division of Hematology/Oncology, Department of Internal Medicine, Hanyang University Hospital, 17, Haeng Dang-dong, Sung Dong-gu, Seoul 133-792, Korea. Tel: +82-2-290-8334, Fax: +82-2-298-9183, leeyy@hanyang.ac.kr

Received: March 24, 2010; Revised: May 19, 2010; Accepted: May 24, 2010

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

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Essential thrombocythemia (ET) is a chronic myeloproliferative disorder with a prolonged clinical course. Since this disorder is considered to be at increased risk of thromboembolism, therapy is mainly focused on the decreased risk of thrombohemorrhagic events by use of cytotoxic agents. Anagrelide is a phosphodiesterase III inhibitor which is utilized in the treatment of ET for the reduction of platelets. However, patients treated with anagrelide might experience cardiovascular adverse effects including myocardial infarction (MI), although these events are rare. Herein, we report a case of a 30-year-old female with well controlled ET by anagrelide, who eventually developed an acute non-ST elevation myocardial infarction (MI). There has no found any cardiovascular risk factors in this ET patient, strongly suggesting that anagrelide might be the cause of MI. Therefore, cardiovascular function should be monitored in those patients prescribed with anagrelide.

Keywords Anagrelide, Essential thrombocythemia, Acute myocardial infarction

Article

Case Report

Korean J Hematol 2010; 45(2): 136-138

Published online June 30, 2010 https://doi.org/10.5045/kjh.2010.45.2.136

Copyright © The Korean Society of Hematology.

Development of acute myocardial infarction in a young female patient with essential thrombocythemia treated with anagrelide: a case report

Young-Hyo Lim1, Young Yiul Lee2*, Jae Hoon Kim1, Jinho Shin1, Jae Ung Lee1, Kyung-Soo Kim1, Soon-Kil Kim1, Jeong Hyun Kim1, and Heon Kil Lim1

1Division of Cardiology, Department of Internal Medicine, College of Medicine, Hanyang University, Seoul, Korea.

2Division of Hematology/Oncology, Department of Internal Medicine, College of Medicine, Hanyang University, Seoul, Korea.

Correspondence to: Correspondence to Young Yiul Lee, M.D., Ph.D. Division of Hematology/Oncology, Department of Internal Medicine, Hanyang University Hospital, 17, Haeng Dang-dong, Sung Dong-gu, Seoul 133-792, Korea. Tel: +82-2-290-8334, Fax: +82-2-298-9183, leeyy@hanyang.ac.kr

Received: March 24, 2010; Revised: May 19, 2010; Accepted: May 24, 2010

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Essential thrombocythemia (ET) is a chronic myeloproliferative disorder with a prolonged clinical course. Since this disorder is considered to be at increased risk of thromboembolism, therapy is mainly focused on the decreased risk of thrombohemorrhagic events by use of cytotoxic agents. Anagrelide is a phosphodiesterase III inhibitor which is utilized in the treatment of ET for the reduction of platelets. However, patients treated with anagrelide might experience cardiovascular adverse effects including myocardial infarction (MI), although these events are rare. Herein, we report a case of a 30-year-old female with well controlled ET by anagrelide, who eventually developed an acute non-ST elevation myocardial infarction (MI). There has no found any cardiovascular risk factors in this ET patient, strongly suggesting that anagrelide might be the cause of MI. Therefore, cardiovascular function should be monitored in those patients prescribed with anagrelide.

Keywords: Anagrelide, Essential thrombocythemia, Acute myocardial infarction

Fig 1.

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Figure 1.

Initial electrocardiograph showing T-wave inversions in leads I, aVL, and V2 through V5, which are consistent with myocardial ischemia.

Blood Research 2010; 45: 136-138https://doi.org/10.5045/kjh.2010.45.2.136

Fig 2.

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Figure 2.

Coronary angiography (CAG) and intravascular ultrasound (IVUS). (A) Left CAG before intracoronary nitroglycerin injection. (B) Left CAG after intracoronary nitroglycerin injection. (C) Plaque rupture and thrombus formation in an IVUS image.

Blood Research 2010; 45: 136-138https://doi.org/10.5045/kjh.2010.45.2.136
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