Abstract Number: PB0008
Meeting: ISTH 2020 Congress
Background: Hereditary angioedema (HAE) is a genetic pathology caused by a deficit of the complement inhibitor (C1-INH). The incidence of HAE combined with Samter´s syndrome (SSx) is low, making diagnosis, treatment and disease monitoring to be difficult.
Aims: To prevent intra stent thrombosis in a patient with HAE, SSx and ischemic heart disease after coronary angioplasty.
Methods: A clinical case of a 67-year-old female patient with HAE due to deficiency of the complement C1-INH inhibitor and SSx who develops aspirin allergy is presented. In 2006, because she manifests complications, receives treatment with nandroparin 2850 IU / 24 hours. With 3-year ischemic heart disease, she underwent catheterization with the presence of a right coronary lesion with stent placement. Upon receiving treatment with clopidrogel 75 mg, the patient begins with adverse reactions of angioedema. Subsequently with ticagregol 90mg / 24 hours evolves with dyspnea on exertion and allergies. Under these circumstances it is decided to prescribe rivaroxaban 2.5mg / 24 hours.
Results: The patient after 6 months of rivaroxaban treatment, is asymptomatic, has no precordial pain, has no electrocardiographic changes of ischemia or cardiovascular manifestations. Laboratory and imaging tests without alarm data.
The aforementioned patient is required dual therapy with Aspirin and Clopidrogel to avoid intra stent thrombosis, however this management by HAE and SSx is not possible, so it is decided to prescribe rivaroxaban, based on the results of the COMPASSS and ATLAS ACS 2-TIMI 51 studies. Rivaroxaban is indicated in the prevention of atherothrombotic events in adult patients after an acute coronary syndrome.
Conclusions: The administration of rivaroxaban can be a safe treatment alternative for patients with HAE and SSx who develop heart disease, reducing the risk of intra stent thrombosis. Our patient with rivaroxaban has evolved favorably during the 6 months of follow-up.
To cite this abstract in AMA style:Zuñiga Ascencio BS, Vidal Martinez F, Castillejos López M, Lira Mendoza BA, Jaime Capetillo ME, Juárez Silva E, Guevara Gutiérrez R. A Case Report of a Patient with Hereditary Angioedema and Samter´s Syndrome Treated with Anticoagulant of Direct Action Anti Xa (Rivaroxaban), Secondary to Angioplasty due to Ischemic Heart Disease [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/a-case-report-of-a-patient-with-hereditary-angioedema-and-samters-syndrome-treated-with-anticoagulant-of-direct-action-anti-xa-rivaroxaban-secondary-to-angioplasty-due-to-ischemic-heart-disea/. Accessed February 21, 2024.
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