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Stenosis in coronary artery, not suitable for angioplasty due to blood coagulation problem. What is the solution?

I am a 74 years old man living in Iran. I have done angiography before and it shows that I have stenosis in 3 of my coronary arteries. My cardiologist doctor said that I should do the angioplasty , and after that I should use antiplatelet drugs like Aspirin. On the other hand, I have blood coagulation problem due to some factors. Thus, my hematology doctor said that antiplatelet drugs are dangerous for me and I must not use them. So, my cardiologist decided not to do the angioplasty, and he did not have any other suggestion. He only said that in critical emergency situation a cardiac surgery may works for me. Indeed, I have heard that in some other countries there are other solutions in my case. Would you please guide me to find a solution for my problem? I can send you my blood test results if it helps. Moreover, I would like to know about the effect of drinking any beer or wine in my situation, and I will appreciate if you help me about this matter as well. Thanks in advance, Sincerely, Reza
Asked On : Sun, 19 Aug 2012
Answers:  1 Views:  50
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Cardiologist 's  Response
Dear sir
As your cardiologist advised you angioplasty but later on postponed it due to coagulation disorder. There are different type of coagulation disorders which can either lead to increased risk of bleeding or increased risk of thrombosis(i.e clot formation in your vessels). it will become more clear if you send me your labs. After angioplasty you need to take atleast two antiplatelet drugs usually for 01 year, so that your stent do not get blocked. and as you are already having coagulation disorder so your risk of bleeding increases further. although there are certain option in your case like proceeding with FFP (that helps the blood to clot) during and after the procedure, or putting a BMS (BARE metal stent, That requires anti platelet drugs for shorter period of time) depending upon the lesion in your coronary arteries, or simply doing balloon angioplasty without stent in emergency case or finally surgery.
I personally feel considering your age, if your symptoms like chest pain or shortness of breath, are well controlled with medicine, then invasive procedures should be undertaken after a very careful thought. As even the angioplasty does not significantly improve the mortality benefit, it only improves your symptoms and quality of life.
As far as alcohol intake is concerned, if you do not have other disease like liver disorders then you can take moderate amount of alcohol (i.e I-2 drinks per day). Although according to some studies wine is preferred over other drinks.
Hope the answer would have helped you to make yourself more clear about your case.
Do let me know if you have other queries.
Dr. Atif Nazir
Answered: Mon, 3 Sep 2012
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