Recurrent acute coronary syndrome after infliximab infusion in a patient with rheumatoid arthritis: Case report

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1. Verfasser: Martin Rebolledo Del Toro
Format: Artículo científico
Sprache:en
Veröffentlicht: Universidad del Valle 2023
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author Martin Rebolledo Del Toro
author_facet Martin Rebolledo Del Toro
contents Recurrent acute coronary syndrome after infliximab infusion in a patient with rheumatoid arthritis: Case report Martin Rebolledo Del Toro Camila Borda Luisa Fernanda Rincón Andrea Castillo Daniel Gerardo Fernández-Ávila Medicina infliximab case report myocardial ischemia Rheumatoid arthritis Case description: A 61-year-old male patient with uncontrolled rheumatoid arthritis presented acute coronary syndrome on three occasions, less than 48 hours after infliximab infusion.Clinical findings: He presented with ST-elevation myocardial infarction on two occasions and non-ST-elevation acute coronary syndrome on one, with the identification of multivessel coronary disease.Treatment and outcome: Coronary intervention was performed with thrombus aspiration, medicated stent implantation, medicated balloon angioplasty, discontinuation of infliximab, and modification and optimization of cardiovascular pharmacological management.Clinical relevance: Patients with rheumatoid arthritis have subclinical cardiovascular disease and increased cardiovascular risk. The evidence regarding the relationship between infliximab and ischemic heart disease is controversial. A wide clinical spectrum of cardiac involvement with infliximab infusion is found in case reports, ranging from stable angina to ST-segment elevation acute coronary syndrome. The pathophysiology is not elucidated, with hypotheses proposing plaque rupture, allergic reactions, and vasoconstriction as possible disease mechanisms. The direct association between infliximab infusion and acute coronary syndrome needs more clinical research to optimize the management and prognosis of patients presenting with this type of complication. 2023 otro 0120-8322 https://www.redalyc.org/articulo.oa?id=28375744005 https://www.redalyc.org/journal/283/28375744005/ https://www.redalyc.org/journal/283/28375744005/html/ https://www.redalyc.org/journal/283/28375744005/28375744005.epub https://www.redalyc.org/journal/283/28375744005/movil http://doi.org/10.25100/cm.v54i2.5466 en http://www.redalyc.org/revista.oa?id=283 Colombia Médica application/pdf Universidad del Valle Colombia Médica (Colombia) Num.2 Vol.54
format Artículo científico
id redalyc_28375744005
institution Redalyc
language en
publishDate 2023
publisher Universidad del Valle
spellingShingle Recurrent acute coronary syndrome after infliximab infusion in a patient with rheumatoid arthritis: Case report
Martin Rebolledo Del Toro
Medicina
infliximab
case report
myocardial ischemia
Rheumatoid arthritis
Recurrent acute coronary syndrome after infliximab infusion in a patient with rheumatoid arthritis: Case report Martin Rebolledo Del Toro Camila Borda Luisa Fernanda Rincón Andrea Castillo Daniel Gerardo Fernández-Ávila Medicina infliximab case report myocardial ischemia Rheumatoid arthritis Case description: A 61-year-old male patient with uncontrolled rheumatoid arthritis presented acute coronary syndrome on three occasions, less than 48 hours after infliximab infusion.Clinical findings: He presented with ST-elevation myocardial infarction on two occasions and non-ST-elevation acute coronary syndrome on one, with the identification of multivessel coronary disease.Treatment and outcome: Coronary intervention was performed with thrombus aspiration, medicated stent implantation, medicated balloon angioplasty, discontinuation of infliximab, and modification and optimization of cardiovascular pharmacological management.Clinical relevance: Patients with rheumatoid arthritis have subclinical cardiovascular disease and increased cardiovascular risk. The evidence regarding the relationship between infliximab and ischemic heart disease is controversial. A wide clinical spectrum of cardiac involvement with infliximab infusion is found in case reports, ranging from stable angina to ST-segment elevation acute coronary syndrome. The pathophysiology is not elucidated, with hypotheses proposing plaque rupture, allergic reactions, and vasoconstriction as possible disease mechanisms. The direct association between infliximab infusion and acute coronary syndrome needs more clinical research to optimize the management and prognosis of patients presenting with this type of complication. 2023 otro 0120-8322 https://www.redalyc.org/articulo.oa?id=28375744005 https://www.redalyc.org/journal/283/28375744005/ https://www.redalyc.org/journal/283/28375744005/html/ https://www.redalyc.org/journal/283/28375744005/28375744005.epub https://www.redalyc.org/journal/283/28375744005/movil http://doi.org/10.25100/cm.v54i2.5466 en http://www.redalyc.org/revista.oa?id=283 Colombia Médica application/pdf Universidad del Valle Colombia Médica (Colombia) Num.2 Vol.54
title Recurrent acute coronary syndrome after infliximab infusion in a patient with rheumatoid arthritis: Case report
topic Medicina
infliximab
case report
myocardial ischemia
Rheumatoid arthritis
url https://www.redalyc.org/articulo.oa?id=28375744005
https://www.redalyc.org/journal/283/28375744005/
https://www.redalyc.org/journal/283/28375744005/html/
https://www.redalyc.org/journal/283/28375744005/28375744005.epub
https://www.redalyc.org/journal/283/28375744005/movil
http://doi.org/10.25100/cm.v54i2.5466