Essential thrombocytosis (ET) is a rare myeloproliferative disorder,
which is a major risk factor for thrombosis and bleeding, which complicates
cardiovascular surgery. ET is a risk factor for coronary artery disease that
should be treated. We present a case of a male with ET who underwent coronary
artery bypass grafting (CABG) at the University Hospital of the West Indies,
and died post-surgery. Post mortem revealed early graft thrombosis. We believe
that post-operative aspirin therapy maybe would have prevented this fatal outcome.
References
[1]
Kumagai, N., Mitsutake, R., Miura, S., Kawamura, A., Takamiya, Y., Nishikawa, H., et al. (2009) Acute Coronary Syndrome Associated with Essential Thrombocythemia. Journal of Cardiology, 54, 485-489. https://doi.org/10.1016/j.jjcc.2009.03.001
Hehlmann, R., Jahn, M., Baumann, B. and Kopcke, W. (1988) Essential Thrombocythemia. Clinical Characteristics and Course of 61 Cases. Cancer, 61, 2487-2496. https://doi.org/10.1002/1097-0142(19880615)61:12<2487::AID-CNCR2820611217>3.0.CO;2-T
[4]
Landolfi, R., Cipriani, M.C. and Novarese, L. (2006) Thrombosis and Bleeding in Polycythemia Vera and Essential Thrombocythemia: Pathogenetic Mechanisms and Prevention. Best Practice & Research Clinical Haematology, 19, 617-633. https://doi.org/10.1016/j.beha.2005.07.011
[5]
Falanga, A., Marchetti, M., Vignoli, A., Balducci, D. and Barbui, T. (2005) Leukocyte-Platelet Interaction in Patients with Essential Thrombocythemia and Polycythemia Vera. Experimental Hematology, 33, 523-530. https://doi.org/10.1016/j.exphem.2005.01.015
[6]
Hasselbalch, H.C. (2015) Smoking as a Contributing Factor for Development of Polycythemia Vera and Related Neoplasms. Leukemia Research, 39, 1137-1145. https://doi.org/10.1016/j.leukres.2015.09.002
Michiels, J.J. (1999) Aspirin and Platelet-Lowering Agents for the Prevention of Vascular Complications in Essential Thrombocythemia. Clinical and Applied Thrombosis/Hemostasis, 5, 247-251. https://doi.org/10.1177/107602969900500408
[9]
Beer, P.A., Erber, W.N., Campbell, P.J. and Green, A.R. (2011) How I Treat Essential Thrombocythemia. Blood, 117, 1472-1482. https://doi.org/10.1182/blood-2010-08-270033
[10]
Ruggeri, M., Rodeghiero, F., Tosetto, A., Castaman, G., Scognamiglio, F., Finazzi, G., et al. (2008) Postsurgery Outcomes in Patients with Polycythemia Vera and Essential Thrombocythemia: A Retrospective Survey. Blood, 111, 666-671. https://doi.org/10.1182/blood-2007-07-102665
[11]
Cortelazzo, S., Finazzi, G., Ruggeri, M., Vestri, O., Galli, M., Rodeghiero, F., et al. (1995) Hydroxyurea for Patients with Essential Thrombocythemia and a High Risk of Thrombosis. The New England Journal of Medicine, 332, 1132-1136. https://doi.org/10.1056/NEJM199504273321704
