Priapism: A very rare complication of dual antiplatelet therapy after percutaneous coronary intervention
Bibliographic record
Abstract
Context: Dual antiplatelet therapy (DAPT), with aspirin and P2Y12 receptor inhibitors, is standard of care in patients with ST elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). However, its use is associated with increased risk of bleeding. We herein report an unusual bleeding complication associated with DAPT after primary PCI. Case Report: A 42-year-old man, who presented with acute inferior wall MI and underwent a successful bare metal placement in circumflex coronary artery, was discharged on dual antiplatelet therapy. However, he presented 2 weeks later with priapism for 20 hours that needed surgical drainage of large amount of blood from his penis. There were no other causes to explain priapism, but since this was not known complication of DAPT, it was not discontinued given his recent stent placement. However, 3 weeks later he suffered another episode of priapism that also needed surgical drainage. Therefore, given its high antiplatelet potency, Prasugrel was eventually discontinued, and the patient was maintained on aspirin only. The decision was guided by optical coherence tomography evaluation of his recent stent to rule out local risks for stent thrombosis. The patient has done well over 14 months of follow up with no cardiac symptoms or recurrence of priapism. Conclusion: To the best of our knowledge, the association between priapism and DAPT was never reported previously. Given the wide use of DAPT after coronary intervention, we believe that interventional cardiologist should be aware of this rare, yet potentially devastating, complication.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".