Essential thrombocytemia and acute coronary syndrome: clinical profile and association with other thromboembolic events.

BACKGROUND

The existence of a relationship between essential thrombocytemia (ET) and acute coronary syndromes (ACS) has been suggested.

METHOD: Data from eleven consecutive patients admitted with ET in the cardiology department were reviewed.

RESULTS

Nine patients (82%) presented with ACS and two with bradycardia. Patients with ACS had a mean age of 67+/-11 years. Risk factors, especially hypertension (6, 66.7%), and smoking (6, 66.7%) were frequent. Average platelet count was 509 778+/-282 126/mm3. Significant coronary lesions were found in five of six patients studied with coronary angiography. During hospitalization, a patient suffered a thrombotic stroke, a massive pulmonary embolism, and partial aortic thrombosis. Another patient had a transient ischemic attack. Discharge treatments were aspirin (78%), clopidogrel (56%), acenocumarol (33%), hydroxyurea (56%) and anagrelide (44%). Three patients (27%) had thromboembolic events during follow-up (median 1.6 years), 2 patients had coronary events and 1 patient had venous thrombosis. There were neither significant haemorrhages nor deaths.

CONCLUSIONS

Patients with ET and ACS have similar profiles to those of traditional ACS with frequent risk factors and significant coronary artery disease. Association with other thrombotic events can be seen during admission and follow-up while haemorrhagic complications seem to be rare.