open access

Vol 65, No 8 (2007)
Other
Published online: 2007-08-29
Submitted: 2012-12-28
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Case report
Antiplatelet therapy can unmask an inherited bleeding disorder. Aspirin-like defect of platelets does not protect against atherosclerosis

Waldemar Elikowski, Ewelina Hanszke, Wiesława Biczysko, Janusz Rzeźniczak, Aleksandra Kruk-Zagajewska, Krystyna Zawilska
Kardiol Pol 2007;65(8):985-991.

open access

Vol 65, No 8 (2007)
Other
Published online: 2007-08-29
Submitted: 2012-12-28

Abstract

Some inherited platelet disorders may be revealed late, as in the presented case of a 68-year-old-man. Recurrent epistaxis following peri-interventional antiplatelet therapy (after three elective percutaneous coronary interventions) and an episode of upper gastrointestinal haemorrhage required aspirin withdrawal and less frequent clopidogrel use. Platelet studies showed an aspirin-like defect resulting in a lack of arachidonate-induced platelet aggregation. During dose-reduced (2-3 times a week) clopidogrel administration ADP-induced platelet aggregation was effectively inhibited and neither important bleeding nor stent thrombosis occurred. The inherited defect of cyclooxygenase-1, responsible for platelet thromboxane synthesis, did not protect the patient against coronary and extra-cardiac atherosclerosis

Abstract

Some inherited platelet disorders may be revealed late, as in the presented case of a 68-year-old-man. Recurrent epistaxis following peri-interventional antiplatelet therapy (after three elective percutaneous coronary interventions) and an episode of upper gastrointestinal haemorrhage required aspirin withdrawal and less frequent clopidogrel use. Platelet studies showed an aspirin-like defect resulting in a lack of arachidonate-induced platelet aggregation. During dose-reduced (2-3 times a week) clopidogrel administration ADP-induced platelet aggregation was effectively inhibited and neither important bleeding nor stent thrombosis occurred. The inherited defect of cyclooxygenase-1, responsible for platelet thromboxane synthesis, did not protect the patient against coronary and extra-cardiac atherosclerosis
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Keywords

aspirin-like defect of platelets; inherited platelet disorders; antiplatelet therapy; atherosclerosis

About this article
Title

Case report
Antiplatelet therapy can unmask an inherited bleeding disorder. Aspirin-like defect of platelets does not protect against atherosclerosis

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 65, No 8 (2007)

Pages

985-991

Published online

2007-08-29

Bibliographic record

Kardiol Pol 2007;65(8):985-991.

Keywords

aspirin-like defect of platelets
inherited platelet disorders
antiplatelet therapy
atherosclerosis

Authors

Waldemar Elikowski
Ewelina Hanszke
Wiesława Biczysko
Janusz Rzeźniczak
Aleksandra Kruk-Zagajewska
Krystyna Zawilska

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