Acute myocardial infarction in patients of nephrotic syndrome: a case series

Thromboembolic complications have been frequently reported in patients with long-lasting nephrotic syndrome (NS). Although thrombotic complications in the venous system are common in patients with NS, arterial thromboses associated with NS are much less common. However, coronary thromboses are extremely rarely observed. So, NS is a rare cause of acute coronary syndrome (ACS). As such, the incidence, pathogenesis, and treatment of these patients have yet to be clearly defined. In the current literature, publications contain less than 15 patients, most of whom are young children.  Serious clotting factor disturbances can be observed, such as changes in platelet hyperfunction, increased plasma fibrinogen, abnormalities of the fibrinolytic system, and acquired deficiencies of coagulation inhibitors. However, increased platelet aggregation and antithrombin III (AT III) deficiency are the most important factors in this hypercoagulable state in the NS. A hypothesis for hypercoagulable state in NS suggests a clinical correlation between thromboembolism and the underlying renal disease (especially minimal change glomerulopathy). Patients with chronic excess proteinuria and long-term exposure to abnormalities of hemostasis and lipid profiles appear to have a high risk of developing cardiovascular disease. In our study, we evaluated the characteristics of eight patients admitted to our hospital with a diagnosis of acute myocardial infarction (AMI) by ECG, clinical presentation and myocardial enzyme. They were all diagnosed NS before AMI. To our knowledge, this is the first study of multiple cases of NS associated with AMI. In this case study, the cases presented here were retrospectively collected from a database of Jinling Hospital in