Author/Authors :
Siddiqui, Muhammad Umer Lakeview Medical Center - Marshfield Clinic, Rice Lake, USA , Galumyan, Yelena Englewood Hospital and Medical Center, Englewood, USA , Klein, James Englewood Hospital and Medical Center, Englewood, USA , Naeem, Zunaira DOW Medical College, Karachi, Pakistan , Schwarcz, Aron Englewood Hospital and Medical Center, Englewood, USA
Abstract :
Introduction. Epoetin alfa is an erythrocyte-stimulating factor. We here present a case of an anemic patient, who was given epogen
before a coronary artery bypass (CABG) surgery and developed periprocedural myocardial infarction. To our knowledge, there
has been no previous case reported of epogen causing myocardial infarction. Case Presentation. 66-year-old female presented with
substernal chest pain. EKG showed ST segment elevations in aVf and L-III. Patient underwent left heart catheterization (LHC) and
had triple vessel disease. A bare metal stent was placed in RCA. Patient continued to have symptoms after discharge and presented
to the ED again with these complaints. She underwent coronary artery bypass surgery (CABG). Before the procedure, patient’s
hemoglobin was 11.1 grams/deciliter and was given epogen to raise hemoglobin level. Postoperative day (POD) #1 patient had ST
elevations in inferior and anterolateral leads. She was diagnosed with periprocedural myocardial infarction. Patient underwent
repeat LHC, which identified obstruction of saphenous vein graft (SVG). Hypercoagulable workup was negative for any disease
and the patient was diagnosed with epogen induced early graft occlusion. Conclusion. Epogen administration can cause myocardial
infarction and coronary artery thrombosis. We suggest that physicians use epogen very cautiously, especially in population who
has underlying coronary artery disease.
