Korean J Hematol.  2010 Jun;45(2):136-138. 10.5045/kjh.2010.45.2.136.

Development of acute myocardial infarction in a young female patient with essential thrombocythemia treated with anagrelide: a case report

• Lim YH
• Lee YY
• Kim JH
• Shin J
• Lee JU
• Kim KS
• Kim SK
• Kim JH
• Lim HK

• KMID: 2083548
• DOI: http://doi.org/10.5045/kjh.2010.45.2.136

Abstract

Essential thrombocythemia (ET) is a chronic myeloproliferative disorder with a prolonged clinical course. Since this disorder is considered to be at increased risk of thromboembolism, therapy is mainly focused on the decreased risk of thrombohemorrhagic events by use of cytotoxic agents. Anagrelide is a phosphodiesterase III inhibitor which is utilized in the treatment of ET for the reduction of platelets. However, patients treated with anagrelide might experience cardiovascular adverse effects including myocardial infarction (MI), although these events are rare. Herein, we report a case of a 30-year-old female with well controlled ET by anagrelide, who eventually developed an acute non-ST elevation myocardial infarction (MI). There has no found any cardiovascular risk factors in this ET patient, strongly suggesting that anagrelide might be the cause of MI. Therefore, cardiovascular function should be monitored in those patients prescribed with anagrelide.

Keyword

Anagrelide; Essential thrombocythemia; Acute myocardial infarction

MeSH Terms

Adult
Blood Platelets
Cyclic Nucleotide Phosphodiesterases, Type 3
Cytotoxins
Female
Humans
Myeloproliferative Disorders
Myocardial Infarction
Quinazolines
Risk Factors
Thrombocythemia, Essential
Thromboembolism
Cyclic Nucleotide Phosphodiesterases, Type 3
Cytotoxins
Quinazolines

Figure

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  Fig. 1 Initial electrocardiograph showing T-wave inversions in leads I, aVL, and V2 through V5, which are consistent with myocardial ischemia.

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  Fig. 2 Coronary angiography (CAG) and intravascular ultrasound (IVUS). (A) Left CAG before intracoronary nitroglycerin injection. (B) Left CAG after intracoronary nitroglycerin injection. (C) Plaque rupture and thrombus formation in an IVUS image.

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