acenocoumarol and Cardiomyopathy--Dilated

We present a case of a 58-year-old male being treated for dilated cardiomyopathy and atrial fibrillation for more than ten years who was admitted to the intensive care unit with the diagnosis of acute ST-segment elevation myocardial infarction (STEMI). In course of further diagnostics the coronary artery embolism resulting from the unintentional anticoagulant drug (acenocumarol) dose reduction was established as the most probable cause of STEMI. Primary percutaneous coronary intervention was successfully performed and the patient was discharged home in good clinical condition.

Topics: Acenocoumarol; Angioplasty, Balloon, Coronary; Anticoagulants; Atrial Fibrillation; Cardiomyopathy, Dilated; Coronary Angiography; Coronary Thrombosis; Electrocardiography; Heart Conduction System; Humans; Male; Middle Aged; Myocardial Infarction; Treatment Outcome

Although the indications for oral anticoagulation (AO) in the treatment of cerebral vascular disease (CVD) are well established, their potential side effects continue to give cause for worry.. To describe the complications and ischemic relapses in patients treated with AO for secondary prevention of CVD of cardiac embolic origin.. We included 169 patients with embologenic cardiopathy who, following an CVD, were treated with AO and followed-up at our medical centre for at least three months. We recorded their past clinical history and risk factors, occurrence of vascular relapses (VR), complications involving hemorrhage (CH), and data regarding course and follow-up.. During an average follow-up of 50.3 months of a total of 707.9 patient/years, 20 VR (2.8% per year) were recorded; 15 of these were cerebro-vascular and mainly mild. We recorded 59 CH in 41 patients (8.3% per year) of which 6 were considered to be major. There was a 30% drop-out rate from follow-up at our centre, mainly due to death from other causes or to change of referral centre.. There is a low incidence of relapse and of complications (usually mild) following AO for the secondary prevention of CVD of cardio-embolic origin. Efficacy and security are maintained in the long term.

Topics: Acenocoumarol; Administration, Oral; Alcoholism; Anticoagulants; Arteriosclerosis; Atrial Fibrillation; Cardiomyopathy, Dilated; Cohort Studies; Comorbidity; Diabetes Mellitus; Disease-Free Survival; Follow-Up Studies; Heart Valve Diseases; Hemorrhage; Humans; Hyperlipidemias; Hypertension; Intracranial Embolism and Thrombosis; Life Tables; Myocardial Infarction; Recurrence; Risk Factors; Smoking; Spain; Treatment Outcome