Percutaneous coronary intervention and the management of acute coronary syndromes in patients with von Willebrand disease

Von Willebrand disease (vWD) results from quantitative or qualitative deficiency of von Willebrand factor (vWF). The occurrence of myocardial infarction is very rare in patients with vWD. A few case reports of acute coronary syndrome (ACS) in vWD patients are present in the literature, but no defini...

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Bibliographic Details
Published in:The Journal of invasive cardiology 2013-04, Vol.25 (4), p.E81-E86
Main Authors: Rathore, Sulaiman, Deleon, Dexter, Akram, Hafsa, Sane, David, Ball, Timothy
Format: Article
Language:English
Subjects:
Acute Coronary Syndrome - epidemiology
Acute Coronary Syndrome - therapy
Comorbidity
Disease Management
Drug Therapy, Combination
Female
Fibrinolytic Agents - therapeutic use
Humans
Middle Aged
Patient Education as Topic
Percutaneous Coronary Intervention - methods
Platelet Aggregation Inhibitors - therapeutic use
Treatment Outcome
von Willebrand Diseases - epidemiology
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Summary:Von Willebrand disease (vWD) results from quantitative or qualitative deficiency of von Willebrand factor (vWF). The occurrence of myocardial infarction is very rare in patients with vWD. A few case reports of acute coronary syndrome (ACS) in vWD patients are present in the literature, but no definite management recommendations are available for such patients. We report a case of successful percutaneous coronary intervention (PCI) with bare-metal stent (BMS) implantation in a 46-year-old woman with type 1 vWD and history of coronary artery disease (CAD). She received periprocedural dual-antiplatelet therapy for 2 weeks and then continued aspirin without any bleeding complications. The optimal management of patients with vWD and ACS is complex and presents a therapeutic challenge. We propose that dual-antiplatelet therapy can be used safely in most vWD patients presenting with ACS as most of them are type 1 vWD. PCI with BMS can be done safely. Long-term management of these patients requires a systemic approach including hematological consultation, ascertaining vWF levels, as well as patient education and close outpatient follow-up.
ISSN:1557-2501