Tenecteplase for ST-elevation myocardial infarction in a patient treated with drotrecogin alfa (activated) for severe sepsis: a case report

Drotrecogin alfa (activated) (DrotAA), an activated protein C, promotes fibrinolysis in patients with severe sepsis. There are no reported cases or studies that address the diagnosis and treatment of myocardial infarction in septic patients treated with DrotAA. A 59-year-old Caucasian man with septi...

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Bibliographic Details
Published in:Journal of medical case reports 2009-11, Vol.3 (1), p.109-109, Article 109
Main Authors: Barra, Lillian, Shum, Jeffrey, Pickering, J Geoffrey, Kao, Raymond
Format: Article
Language:English
Subjects:
Case report
Case studies
Diagnosis
Drotrecogin alfa
Drug therapy
Health aspects
Heart attack
Risk factors
Tenecteplase
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Summary:Drotrecogin alfa (activated) (DrotAA), an activated protein C, promotes fibrinolysis in patients with severe sepsis. There are no reported cases or studies that address the diagnosis and treatment of myocardial infarction in septic patients treated with DrotAA. A 59-year-old Caucasian man with septic shock secondary to community-acquired pneumonia treated with DrotAA, subsequently developed an ST-elevation myocardial infarction 12 hours after starting DrotAA. DrotAA was stopped and the patient was given tenecteplase thrombolysis resulting in complete resolution of ST-elevation and no adverse bleeding events. DrotAA was restarted to complete the 96-hour course. The sepsis resolved and the patient was discharged from hospital. In patients with severe sepsis or septic shock complicated by myocardial infarction, it is difficult to determine if the myocardial infarction is an isolated event or caused by the sepsis process. The efficacy and safety of tenecteplase thrombolysis in septic patients treated with DrotAA need further study.
ISSN:1752-1947
1752-1947
DOI:10.1186/1752-1947-3-109