Large intracoronary thrombi with good TIMI flow during acute myocardial infarction: four cases of successful aggressive medical management in patients without angiographically detectable coronary atherosclerosis.
Four cases of young patients with acute myocardial infarction are discussed in which urgent angiography showed large intracoronary thrombus and TIMI (thrombolysis in myocardial infarction) flow > or = 2 in the infarct related artery. The rest of the coronary tree appeared to be free of detectable atherosclerosis. Percutaneous transluminal coronary angioplasty was not performed and an aggressive antiplatelet/anticoagulant treatment was administered (acetylsalicylic acid, clopidogrel, abciximab, and heparin). In all cases early angiographic control (1-12 days after AMI) showed disappearance of thrombus, no significant residual stenosis, and normal flow. No deterioration of left ventricular function was observed and the clinical course both in hospital and at five months' follow up was uneventful.
Burzotta
F
F
Department of Cardiovascular Diseases, S Giovanni Hospital, Rome, Italy. f.burzotta@eudoramail.com
Hamon
M
M
Sabatier
R
R
Prati
F
F
Boccanelli
A
A
Grollier
G
G
D000077284:Abciximab; D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use*; D001241:Aspirin / Q000627:therapeutic use; D000077144:Clopidogrel; D003326:Coronary Circulation / Q000502:physiology; D003328:Coronary Thrombosis / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D004359:Drug Therapy, Combination; D005260:Female; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology* / Q000503:physiopathology; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D013988:Ticlopidine / Q000031:analogs & derivatives* / Q000627:therapeutic use
D000911:Antibodies, Monoclonal; D000925:Anticoagulants; D007140:Immunoglobulin Fab Fragments; D010975:Platelet Aggregation Inhibitors; D006493:Heparin; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin; D000077284:Abciximab