{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:02:03Z","timestamp":1753891323680,"version":"3.41.2"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,10,10]],"date-time":"2023-10-10T00:00:00Z","timestamp":1696896000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Coronary artery disease (CAD) management in the setting of immune thrombocytopenia (ITP) remains very challenging to clinicians as a reasonable balance between bleeding and thrombosis risks needs to be achieved, and the evidence guiding such management is scarce.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a systematic review following the PRISMA guidelines to summarize the available literature on the management and outcomes of CAD coexisting with ITP. We searched PubMed and Embase for studies published in English exploring CAD and ITP management until 05 October 2022. Two independent reviewers screened and assessed the articles for inclusion. Patients' characteristics, CAD treatment modalities, ITP treatment, and complications were reported.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified 32 CAD cases, among which 18 cases were revascularized with percutaneous coronary intervention (PCI), 12 cases underwent coronary artery bypass graft surgery (CABG), and two cases were managed conservatively. More than 50% were men, with a mean age of 61 \u00b1 13 years and a mean baseline platelet count of 52 \u00b1 59 \u00d7 10<jats:sup>9<\/jats:sup>\/L. Irrespective of the revascularization modality, most patients were treated with either corticosteroids alone, intravenous immunoglobulins (IVIG) alone, or in combination. Among those who underwent PCI, two patients had bleeding events, and one patient died. Similarly, among those with CABG, one patient developed bleeding, and one patient died.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We found that revascularization with either PCI or CABG with the concurrent use of corticosteroids and\/or IVIG for ITP was feasible, with an existing non-negligible risk of bleeding and mortality.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2023.1213275","type":"journal-article","created":{"date-parts":[[2023,10,10]],"date-time":"2023-10-10T07:27:26Z","timestamp":1696922846000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Concurrent coronary artery disease and immune thrombocytopenia: a systematic review"],"prefix":"10.3389","volume":"10","author":[{"given":"Alaa","family":"Rahhal","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Drew","family":"Provan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khaled","family":"Shunnar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mostafa","family":"Najim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashraf Omer","family":"Ahmed","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Waail","family":"Rozi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Murtadha","family":"Al-Khabori","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahmoud","family":"Marashi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mona","family":"AlRasheed","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hani","family":"Osman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed","family":"Yassin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2023,10,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"3829","DOI":"10.1182\/bloodadvances.2019000966","article-title":"American Society of Hematology 2019 guidelines for immune thrombocytopenia","volume":"3","author":"Neunert","year":"2019","journal-title":"Blood Adv."},{"key":"B2","doi-asserted-by":"publisher","first-page":"e123","DOI":"10.1161\/CIR.0000000000000404","article-title":"2016 ACC\/AHA guideline focused update on duration of dual antiplatelet therapy in patients with coronary artery disease: a report of the american college of cardiology\/american heart association task force on clinical practice guidelines: An update of the 2011 ACCF\/AHA\/SCAI guideline for percutaneous coronary intervention, 2011 ACCF\/AHA guideline for coronary artery bypass graft surgery, 2012 ACC\/AHA\/ACP\/AATS\/PCNA\/SCAI\/STS guideline for the diagnosis and management of patients with stable ischemic heart disease, 2013 ACCF\/AHA guideline for the management of ST elevation myocardial infarction, 2014 AHA\/ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes, and 2014 ACC\/AHA guideline on perioperative cardiovascular evaluation and management of patients undergoing noncardiac surgery","volume":"134","author":"Levine","year":"2016","journal-title":"Circulation."},{"key":"B3","doi-asserted-by":"publisher","first-page":"2569","DOI":"10.1093\/eurheartj\/ehs215","article-title":"ESC guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation, the task force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology (ESC)","volume":"33","author":"Steg","year":"2012","journal-title":"Eur Heart J."},{"key":"B4","doi-asserted-by":"publisher","first-page":"1929","DOI":"10.1161\/CIRCRESAHA.114.302737","article-title":"Antiplatelet and anticoagulation therapy for acute coronary syndromes","volume":"114","author":"Bhatt","year":"2014","journal-title":"Circ Res."},{"key":"B5","doi-asserted-by":"publisher","first-page":"390","DOI":"10.1093\/eurheartj\/ehv443","article-title":"Longterm dual antiplatelet therapy for secondary prevention of cardiovascular events in the subgroup of patients with previous myocardial infarction: A collaborative metaanalysis of randomized trials","volume":"37","author":"Udell","year":"2016","journal-title":"Eur Heart J."},{"key":"B6","doi-asserted-by":"publisher","first-page":"2892","DOI":"10.1161\/01.CIR.99.22.2892","article-title":"Clinical significance of thrombocytopenia during a non-ST-elevation acute coronary syndrome. 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