Saratov JOURNAL of Medical and Scientific Research

Treatment tactics for gastrointestinal bleeding following percutaneous coronary intervention for myocardial infarction with development of no-reflow syndrome (clinical case)

Year: 2021, volume 17 Issue: №3 Pages: 458-460
Heading: Cardiology Article type: Case report
Authors: Kosheleva N.A., Kharlamov V.E., Kashkina E.I.
Organization: Saratov Regional Clinical Hospital, Saratov State Medical University

This clinical case demonstrates that percutaneous coronary intervention indicated in the treatment of ST-segment elevation myocardial infarction. Successful percutaneous coronary intervention may result in no-reflow syndrome. Drug therapy of myocardial infarction with ST segment elevation and no-reflow syndrome is accompanied by the introduction of a large number of antithrombotic drugs. The prescription of triple antiplatelet, anticoagulant therapy significantly increases the risk of gastrointestinal bleeding, especially in patients with a history of ulcer disease. The practitioner doctor being prepared for such a complication of this therapy, take timely measures to stop it, and use proton pump inhibitors for the purpose of gastroprotection.

1. Eurasian Clinical Guidelines for the Diagnosis and Treatment of ST-Segment Elevation Acute Coronary Syndrome (ACSpST). Eurasian Cardiology Journal 2020; (1): 4-77. DOI: 10.24411/2076-4766-2020-10001.
2. ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST segment elevation. Eur Heart J 2012; (33): 2569619.
3. Otdelnov LA, Mukhin AS, Mastyukova AM, Tsyganova YuE. Gastrointestinal bleeding in patients in the acute period of myocardial infarction: literature review. Man and His Health 2020; (3): 11-9.
4. Mayev IV, Samsonov АА, Godilo-Godlevskiy VA, et al. Drug interaction of proton pump inhibitors and clopidogrel taken together. Klinicheskaya Meditsina 2013; 91 (5): 15-21.
5. Kwok CS, Sirker A, Farmer AD, et al. Inhospital gastrointestinal bleeding following percutaneous coronary intervention. British Cardiovascular Intervention Society (BCIS) and National Institute of Cardiovascular Outcomes Research (NICOR). Catheter Cardiovasc Interv. 2020; 95(1): 109-17. DOI: 10.1002/ccd. 28222.
6. Daugherty SL, Thompson LE, Kim S, et al. Patterns of use and comparative effectiveness of bleeding avoidance strategies in men and women following percutaneous coronary interventions. An observational study from the National Cardiovascular Data Registry. J Am Coll Cardiol 2013; 61 (20): 2070-8.
7. Ndrepepa G, Stephan T, Fiedler KA, et al. Procedure-related bleeding in elective percutaneous coronary interventions. European Journal of Clinical Investigation 2015; (45): 263-73.
8. Ben-Dor I, Torguson R, Scheinowitz M, et al. Incidence, correlates, and clinical impact of nuisance bleeding after antiplatelet therapy for patients with drug-eluting stents. Am Heart Journal 2010; 159 (5): 871-5.
9. Lee KW, Norell MS. Management of «no-reflow» complicating reperfusion therapy. Acute Card Care 2008; 10 (1): 5-14.

2021_03_458-460.pdf261.29 KB

No votes yet