Development of acute coronary syndrome in three patients with essential thrombocythemia or polycythemia vera

Little is known about the management of coronary thrombosis in myeloproliferative disease. The occurrence of myocardial infarction in myeloproliferative disease is mostly attributed to coronary thrombosis due to hyperviscosity and thrombocytosis. We presented three cases of acute myocardial infarction associated with polycythemia vera in one patient (male, age 33 years) and essential thrombocytosis in two patients (male, ages 36 and 46 years). None of the patients had diabetes mellitus, hypertension, hyperlipidemia, or a positive family history. One patient with early presentation received thrombolytic therapy, and all the patients were treated with aspirin, beta-blocker, angiotensin 2 receptor blocker, statin, lowmolecular- weight heparin, parenteral nitrate, and clopidogrel for acute coronary syndrome, and hydroxyurea for essential thrombocytosis. Control angiographies showed patent coronary arteries in all the cases.