One case of death in a patient with coronary heart disease complicated with rheumatoid arthritis after PCI

doi:10.3877/cma.j.issn.2095-655X.2024.04.005

Abstract

Abstract:

Objective

To explore the mechanism of stent thrombosis after percutaneous coronary intervention （PCI） in a patient with coronary heart disease and rheumatoid arthritis （RA），and to explore the indications and timing of PCI.

Methods

The clinical data of a patient with coronary heart disease complicated with RA who died after PCI in the Department of Cardiology of the Affiliated Hospital of Jining Medical University on March 5，2021 were selected，and the relevant literature was reviewed.

Results

The patient had a 30-year history of RA，which was poorly controlled by long-term use of hormone drugs，and the pain worsened in the past 10 days.The patient had a 10-year history of coronary heart disease and underwent PCI.The anti-cyclic citrulline peptide antibody was 85.33 U/mL，rheumatoid factor 66.61 U/mL，erythrocyte sedimentation rate 42 mm/h，C-reactive protein 17.4 mg/L，and D-dimer 0.66 mg/L.On March 14，2021，preoperative coronary angiography showed acute stent thrombosis.On March 16，2021，coronary angiography showed 90% stenosis in the proximal segment of left anterior descending （LAD） and 95% stenosis in the opening of D1 branch.The patient underwent PCI and a stent was implanted in the proximal segment of the LAD.Thirty minutes after the operation，the patient felt severe pain in the precordial area.Emergency coronary angiography showed thrombosis in the LAD stent，and the thrombolysis in myocardial infarction flow grade was 0.After active treatment，the patient died.

Conclusions

Coronary heart disease patients with RA in the acute phase are prone to stent thrombosis after PCI.It is necessary to fully evaluate the indications and choose the appropriate time before PCI.

Key words: Rheumatoid arthritis, Coronary heart disease, Percutaneous coronary intervention, Stents, Thrombosis

Tong Shen, Cheng Shen, Yanyan Zhang, Xinzhuo Yan, Lijun Gan. One case of death in a patient with coronary heart disease complicated with rheumatoid arthritis after PCI[J]. Chinese Journal of Diagnostics(Electronic Edition), 2024, 12(04): 241-244.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhzdxdzzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-655X.2024.04.005

https://zhzdxdzzz.cma-cmc.com.cn/EN/Y2024/V12/I04/241

Figures/Tables 1

References 16

［1］	Li H，Sun K，Zhao R，et al.Inflammatory biomarkers of coronary heart disease［J］.Front Biosci（Schol Ed），2018，10（1）：185-196.DOI：10.2741/s508.
［2］	Ullrich H，Münzel T，Gori T.Coronary stent thrombosis-predictors and prevention［J］.Dtsch Arztebl Int，2020，117（18）：320-326.DOI：10.3238/arztebl.2020.0320.
［3］	Yuan S，Carter P，Mason AM，et al.Genetic liability to rheumatoid arthritis in relation to coronary artery disease and stroke risk［J］.Arthritis Rheumatol，2022，74（10）：1638-1647.DOI：10.1002/art.42239.
［4］	Avina-Zubieta JA，Thomas J，Sadatsafavi M，et al.Risk of incident cardiovascular events in patients with rheumatoid arthritis：a metaanalysis of observational studies［J］.Ann Rheum Dis，2012，71（9）：1524-1529.DOI：10.1136/annrheumdis-2011-200726.
［5］	Rezuş E，Macovei LA，Burlui AM，et al.Ischemic heart disease and rheumatoid arthritis-two conditions，the same background［J］.Life（Basel），2021，11（10）：1042.DOI：10.3390/life11101042.
［6］	Zhang SQ，Niu QK，Tong L，et al.Identification of the susceptible genes and mechanism underlying the comorbid presence of coronary artery disease and rheumatoid arthritis： a network modularization analysis［J］.BMC Genomics，2023，24（1）：411.DOI：10.1186/s12864-023-09519-7.
［7］	Husarchuk AG，Ilashchuk TO，Okipniak IV，et al.Parameters of endothelial dysfunction and immune response in patients with rheumatoid arthritis with and without ischemic heart disease［J］.Wiad Lek，2022，75（8 pt 2）：1985-1990.DOI：10.36740.
［8］	Ketfi C，Boutigny A，Mohamedi N，et al.Risk of venous thromboembolism in rheumatoid arthritis［J］.Joint Bone Spine，2021，88（3）：105122.DOI：10.1016/j.jbspin.2020.105122.
［9］	Badimon L，Peña E，Arderiu G，et al.C-reactive protein in atherothrombosis and angiogenesis［J］.Front Immunol，2018（9）：430.DOI：10.3389/fimmu.2018.00430.
［10］	Singh AS，Atam V，Yathish BE，et al.Role of erythrocyte sedimentation rate in ischemic stroke as an inflammatory marker of carotid atherosclerosis［J］.J Neurosci Rural Pract，2014，5（1）：40-45.DOI：10.4103/0976-3147.127870.
［11］	赵宇航.类风湿性关节炎合并静脉血栓的危险因素分析［D］.呼和浩特：内蒙古医科大学，2022.DOI：10.27231/d.cnki.gnmyc.2021.000162.
［12］	Xue L，Tao L，Li X，et al.Plasma fibrinogen，D-dimer，and fibrin degradation product as biomarkers of rheumatoid arthritis［J］.Sci Rep，2021，11（1）：16903.DOI：10.1038/s41598-021-96349-w.
［13］	Giannitsis E，Mair J，Christersson C，et al.How to use D-dimer in acute cardiovascular care［J］.Eur Heart J Acute Cardiovasc Care，2017，6（1）：69-80.DOI：10.1177/2048872615610870.
［14］	Keller K，Beule J，Balzer JO，et al.D-dimer and thrombus burden in acute pulmonary embolism［J］.Am J Emerg Med，2018，36（9）：1613-1618.DOI：10.1016/j.ajem.2018.01.048.
［15］	沈吉林，谢兴宇.大剂量糖皮质激素引起颅内静脉窦血栓形成1 例［J］.中国现代医药杂志，2017，19（10）：66-67.DOI：10.3969/j.issn.1672-9463.2017.10.022.
［16］	Kim SC，Solomon DH，Liu J，et al.Risk of venous thromboembolism in patients with rheumatoid arthritis：initiating disease-modifying antirheumatic drugs［J］.Am J Med，2015，128（5）：539.e7-e17.DOI：10.1016/j.amjmed.2014.11.025.

[1]	Boran Wang, Chunmei Qiao, Chunge Li, Xin Wang, Xiaolei Wang. Value of contrast-enhanced ultrasound in assessing progression of subclinical synovitis in patients with rheumatoid arthritis [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2024, 21(08): 802-808.
[2]	Kunpeng Cao, Xinyue Wang, Liuxi Wu, Hongyan Deng, Lu Li, Chaoli Xu, Xinhua Ye. Risk factors for internal jugular venous thrombosis in patients with lymphoma after ultrasound-guided internal jugular vein catheterization [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2024, 21(03): 310-318.
[3]	Yanting Pu, Cuixian Wu, Yumei Lan. Nomograph model for predicting risk of osteoporoticpatients with rheumatoid arthritis [J]. Chinese Journal of Joint Surgery(Electronic Edition), 2024, 18(05): 596-603.
[4]	Xiao Wang, Yifan Li, Suhong Shen, Guorui Cao, Xiaotao Shi, Yanhao Yuan, Honglue Tan. Temporal and spatial patterns of early postoperative deep vein thrombosis in lower extremities following total knee arthroplasty [J]. Chinese Journal of Joint Surgery(Electronic Edition), 2024, 18(03): 414-420.
[5]	Shanshan Wu, Yumin Pan, Jin Liu, Jinsong Zhang, Li Qiao. Incidence of venous thromboembolism in patients with obstructive sleep apnea syndrome: a meta-analysis [J]. Chinese Journal of Critical Care Medicine(Electronic Edition), 2024, 17(04): 312-317.
[6]	Jinhan Yao, Weina Wang, Yuquan Zhang. Current research status on prognosis of patients with pregnancy-related deep vein thrombosis [J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2024, 20(04): 367-373.
[7]	Xingyue Li, Wei Dong, Yongbo Xu, Wenfa Zhang, Xiaoxuan Hu, Yuxu Zhong, Haibo Chu. Expression of matrix metalloproteinases and their tissue inhibitors in the vein wall following superficial venous thrombosis [J]. Chinese Archives of General Surgery(Electronic Edition), 2024, 18(05): 338-343.
[8]	Meini Ye, Sijia Liu, Yuwei Zang, Yunjian Liu. Research progress on portal vein thrombosis in liver cirrhosis [J]. Chinese Archives of General Surgery(Electronic Edition), 2024, 18(05): 379-384.
[9]	Daocheng Fang, Lixin Chen, Yuanyuan Hu. Research progress on ureteral stent crusts [J]. Chinese Journal of Endourology(Electronic Edition), 2024, 18(04): 402-405.
[10]	Xianjie Wei, Hesuyuan Huang, Keshi Zhang, Zhenpeng Guan. Kaempferide reduces chondrocyte inflammation and matrix degradation in a rat model of rheumatoid arthritis by inhibiting NF-κB signaling [J]. Chinese Journal of Clinicians(Electronic Edition), 2024, 18(04): 375-382.
[11]	ChaoPeng Mou, Bin Zong, Yi Liu, Meiying Shi, Dujuan Xu, Chunguang Feng. Access-site hematoma in distal and conventional transradial access in patients undergoing emergency coronary angiography or percutaneous coronary intervention [J]. Chinese Journal of Clinicians(Electronic Edition), 2024, 18(03): 275-282.
[12]	Fangming Guo, Mingli Zhao, Fanhui Yan, Mengmeng Liu, Yang Wang, Yingjie Zhao, Yuanhang Liu, Yanfen Zhang, Jingdong Zhan. Optical coherence tomography in the application of layered coronary plaque lesions in acute myocardial infarction [J]. Chinese Journal of Diagnostics(Electronic Edition), 2024, 12(02): 73-79.
[13]	Xin Tang, Wenhai Zhai, Runting Wang, Shengyu Zhou, Hang Jin. Research progress on the role of complement in ischemic stroke [J]. Chinese Journal of Cerebrovascular Diseases(Electronic Edition), 2024, 18(04): 382-392.
[14]	Hongqian Zhou, Yukun Zhang, Tianshu Gu, Sutao Hu, Chao Jiang, Xue Zhang, Hao Zhang, Huayue Tao, Xing Liu, Tong Liu, Kangyin Chen. Analysis of risk factors for adverse prognosis in patients with previous hemorrhagic stroke undergoing percutaneous coronary intervention [J]. Chinese Journal of Cerebrovascular Diseases(Electronic Edition), 2024, 18(04): 323-329.
[15]	Yaping Zhou, Yuehui Hong, Ning Su, Bao Liu, Tienan Zhu, Jun Ni. Clinical treatment strategies for cerebral amyloid angiopathy with thrombotic conditions [J]. Chinese Journal of Cerebrovascular Diseases(Electronic Edition), 2024, 18(04): 338-344.

Please choose a citation manager

Content to export