Acute Promyelocytic Leukemia as a Cause of Intracoronary Drug-Eluting-Stent Thrombosis

Stent thrombosis is a potentially lethal complication of percutaneous coronary intervention. We describe the case of a 51-year-old man who presented with acute anterior ST-segment-elevation myocardial infarction and underwent successful percutaneous transluminal coronary angioplasty and placement of 3 drug-eluting stents in the left anterior descending coronary artery. Despite receiving dual antiplatelet therapy, the patient presented a week later with a non-ST-segment-elevation myocardial infarction and was found to have nonocclusive thrombosis of the left anterior descending coronary artery stents and his ostial left main and left circumflex coronary arteries. Subsequently, bone marrow biopsy analysis indicated that the patient had acute myelogenous leukemia, which we believe was the underlying cause of his prothrombotic state and stent thrombosis. (Tex Heart Inst J 2012;39(3):416-9)