Percutaneous coronary intervention in a patient with von Willebrand's disease presenting with an acute coronary syndrome.
The optimal management strategy for patients with von Willebrand's disease presenting with acute coronary syndromes is unclear. We present a clinical case of percutaneous coronary intervention following an acute coronary syndrome in a man with von Willebrand's disease. Other published case reports are reviewed. The central role of von Willebrand factor in the pathophysiology of acute coronary syndrome and the possible cardioprotective effects of low levels of the protein are discussed. Practical considerations regarding hemostasis and antiplatelet therapy are addressed. Finally, recommendations for the management of patients with von Willebrand's disease presenting with acute coronary syndromes are suggested.
Macdonald
John
J
Blackpool Victoria Hospital, United Kingdom.
Srinivasan
Manivannan
M
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Ranjit
R
D000208:Acute Disease; D015906:Angioplasty, Balloon, Coronary; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use; D000077144:Clopidogrel; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy*; D004844:Epistaxis / Q000139:chemically induced; D006493:Heparin / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D015607:Stents; D013577:Syndrome; D013988:Ticlopidine / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use; D014842:von Willebrand Diseases / Q000150:complications*
D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors; D006493:Heparin; D000077144:Clopidogrel; D013988:Ticlopidine