British Medical Journal (BMJ) Case Report Features Patient with  Immune Thrombocytopenic Purpura

HONG KONG – OrbusNeich today announced the publication of a case report demonstrating that revascularization with the Genous Stent may enable the safe and early discontinuation of dual antiplatelet therapy (DAPT) for challenging patients with an increased risk of bleeding, particularly during the procedure.

The case study, published in BMJ online, features a patient with chronic immune thrombocytopenic purpura (ITP) who was diagnosed with unstable angina due to a critical stenosis (90%) at the ostium of the left anterior descending (LAD) artery and a 75% stenosis of the proximal LAD artery. It was intended that the patient, who was

treated with two Genous Stents, receive only one month of DAPT following the procedure. However, due to extensive bruising in the patient’s forearm from antiplatelet use, the initial one month of DAPT was stopped after three days and restarted one week later when the ecchymosis was resolving. At 12-month follow-up, the patient remained asymptomatic.

"Chronic ITP is characterized by premature destruction of autoantibody-coated platelets causing persistent thrombocytopenia and increased risk of bleeding," said Charles Chan, M.D., Gleneagles Medical Center, Singapore. "Additionally, ITP patients may also have an increased risk of thrombosis versus the general population and those patients with acquired thrombocytopenia. The Genous Stent has been shown to be safe and effective in high-risk patients with ST-segment elevation acute myocardial infarction (STEAMI) and has not been associated with increased rates of late stent thrombosis when accompanied by only one month of DAPT. Thus, the Genous Stent may provide a safer option for patients, such as those with ITP, who have an increased risk of bleeding and are therefore contraindicated to long-term DAPT."

The 55-year-old male patient had a week-long history of unstable angina and was diagnosed with hypertension and hyperlipidemia as risk factors for coronary artery disease (CAD). He was diagnosed with ITP 20 years prior and did not receive long-term steroid treatment or splenectomy. The patient received DAPT and prednisone three days in advance of the procedure and was transfused with six units of platelets on the third day prior to coronary stenting.

Source: OrbusNeich