Korean Circ J.  2003 Jun;33(6):523-527. 10.4070/kcj.2003.33.6.523.

A Successful Management for Acute Thrombotic Myocardial Infarction with Abciximab in a Nephrotic Syndrome

• Park OY
• Jeong MH
• Cho YW
• Lee SH
• Shim DS
• Yang BR
• Hong YJ
• Lee SH
• Park WS
• Kim W
• Kim JH
• Ahn YK
• Cho JG
• Park JC

• KMID: 1858820
• DOI: http://doi.org/10.4070/kcj.2003.33.6.523

Abstract

A 28-year old male presented with chest pain of two hours duration. He had histories of 10 years smoking and 2 years of nephrotic syndrome, due to minimal change disease. His EKG showed marked ST segment elevations in the V3-6, I, II, III and aVF leads. The levels of cardiac enzymes were increased (CK: 481 U/l, CK-MB: 96 U/l and Troponin I: 4.8 ng/mL). The prothrombin and activated partial promboplastin times were normal. Accelerated tissue type plasminogen activator (100 mg) was administered at the emergency room, but his chest pain continued, with persistent ST segment elevations. An urgent coronary angiograph revealed huge multiple filling defects, suggestive of thrombi in the proximal left anterior descending artery (LAD), with thrombolysis in the myocardial infarction (TIMI) flow. A rescue percutaneous coronary intervention was performed using repeated angioplasties with a 3.0 mm balloon. However, the filling defects and distal LAD flow did not improve. We administered Abciximab (ReoPro(r)), and the LAD flow improved to a TIMI III flow, with resolution of the thrombus in the LAD. His clinical course was uneventful after discharge, and a left coronary angiogram, at the 6-month follow-up, showed no filling defects, with the TIMI III flow maintained.

Keyword

Myocardial infarction; Thrombosis; Nephrotic syndrome; Blood platelets; Angioplasty

MeSH Terms

Adult
Angioplasty
Arteries
Blood Platelets
Chest Pain
Electrocardiography
Emergency Service, Hospital
Follow-Up Studies
Humans
Male
Myocardial Infarction*
Nephrosis, Lipoid
Nephrotic Syndrome*
Percutaneous Coronary Intervention
Prothrombin
Smoke
Smoking
Thrombosis
Tissue Plasminogen Activator
Troponin I
Prothrombin
Smoke
Tissue Plasminogen Activator
Troponin I