Balancing Thrombosis and Bleeding: A Case Report of Acute Myocardial Infarction in an Elderly Patient With Hemophilia A

Vollständiger Abstract

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ABSTRACT Hemophilia A combined with acute myocardial infarction (AMI) is rare and challenging to treat. This article reports a 65‐year‐old patient with hemophilia A admitted for acute inferior ST‐segment elevation myocardial infarction, who successfully underwent emergency drug‐coated balloon (DCB) angioplasty with factor VIII replacement support. Dual antiplatelet therapy (DAPT) was discontinued 3 weeks after the operation, after which the patient received neither antithrombotic therapy nor replacement therapy, while comprehensive risk factor control was intensified. No recurrent thrombotic or hemorrhagic events were observed during the 1‐year follow‐up. This case suggests that the DCB strategy can shorten the required duration of antithrombotic treatment, and discontinuing antithrombotic and replacement therapies may be safe for selected patients, with comprehensive risk factor control serving as the core antithrombotic intervention at this stage.