Evaluation of repeated progression of native coronary artery stenosis by optical frequency domain imaging in a patient with essential thrombocytosis.

Essential thrombocytosis (ET) is a myeloproliferative disorder with abnormal proliferation of the megakaryocytes and is manifested clinically by the overproduction of dysfunctional platelets, leading to thrombus formation. Therefore, the accurate evaluation of the morphological features for coronary stenosis and initiation of appropriate treatment may be life-saving for ET patients. In this report, we describe a case of the rapid development of repeated stenosis in the native coronary artery in an ET patient, and optical frequency domain imaging confirmed the etiology of the stenoses. These findings may be helpful for consideration of etiology and therapeutic strategy for thrombotic complications in ET patients. <Learning objective: Although coronary thrombosis could occur in essential thrombocytosis patients with particularly high platelet counts, strong antiplatelet therapy with the use of multiple antiplatelet agents together with a cytoreductive drug for maintaining peripheral platelet count under 60 × 104/mm3 should be considered to reduce the risk of recurrence of coronary events. An accurate assessment of lesion morphology and patient-tailored management can reduce morbidity and mortality in this population.>.