Balancing Thrombosis and Bleeding: A Case Report of Acute Myocardial Infarction in an Elderly Patient With Hemophilia A.
Dehua Huang, Xi Yang, Xianglan Zhang et al.
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Case in brief
A 65-year-old patient with hemophilia A presented with acute inferior ST-segment elevation myocardial infarction. Emergency drug-coated balloon angioplasty was performed with factor VIII replacement support. Dual antiplatelet therapy was stopped 3 weeks after the procedure; the patient then received neither antithrombotic nor replacement therapy, alongside intensified comprehensive risk-factor control. No recurrent thrombotic or hemorrhagic events were reported during 1-year follow-up.
What made this case unusual
The case involved balancing acute coronary treatment against bleeding risk in a patient with hemophilia A; drug-coated balloon angioplasty was used with factor VIII support, followed by early cessation of dual antiplatelet therapy.
Diagnostic / clinical pearl
In this selected case, drug-coated balloon angioplasty with factor VIII support was followed by discontinuation of dual antiplatelet therapy after 3 weeks without reported recurrent events during 1-year follow-up.
Why it matters
The report illustrates a potential approach to limiting antithrombotic exposure when treating myocardial infarction in a patient with hemophilia A, while emphasizing comprehensive risk-factor control.