Very late coronary drug-eluting stent thrombosis in a patient with essential thrombocythemia: a case report of a rare association

Abstract

Very late coronary stent thrombosis is a rare and dangerous complication associated with the use of drug-eluting stents. From registries and trials only a few predictable risk factors have been identified, though not specifically associated with this phenomenon, such as early discontinuation of dual antiplatelet therapy, diabetes mellitus, renal failure, and complex coronary lesions. Essential thrombocythemia, a rare myeloproliferative disorder characterized by increased platelet count and megakaryocytic hyperplasia in the bone marrow, is rarely associated with ischemic cardiac events or coronary stent thrombosis. We describe a case of very late coronary drug-eluting stent thrombosis in a patient affected by essential thrombocythemia and with a platelet count of 780 000/mm3, presenting with acute myocardial infarction. In our opinion, this case report enriches the poor literature about the association between two so rare conditions; moreover, to our knowledge, this is the first case described in the literature of very late coronary stent thrombosis in a patient with this prothrombotic feature.