STEMI in a Patient With Severe Thrombocytopenia
A 79-year-old male patient with a history of coronary artery disease and complicated percutaneous coronary intervention (PCI) (covered stent to proximal left anterior descending artery [LAD] to treat perforation 4 years prior to presentation) and multiple myeloma presents to the emergency department with acute substernal chest pain and shortness of breath for 1 hour. He had undergone a stem cell transplant 10 days prior and was receiving chemotherapy at the time of presentation. His clopidogrel was stopped a week prior to admission due to thrombocytopenia. His medications at presentation included aspirin and rosuvastatin. His blood pressure was 94/70 mmHg; heart rate was 84 bpm; and respiratory rate was 16/min. The initial electrocardiogram showed ST elevation in the anteroseptal leads and I, aVL along with anterior hyperacute T waves and reciprocal changes in inferior leads, suggesting a proximal LAD occlusion (Figure 1). A day prior to presentation, his platelet count was 38,000/mcl. He went emergently for angiography, which showed the following abnormality in the LAD artery (Figure 2).
Which of the following statements is true regarding myocardial infarction in patients with thrombocytopenia?