Abstract
A 66 year-old male with a history of hypertension and poor follow-up for chronic lymphocytic leukemia (CLL) experienced two episodes of non-ST elevation myocardial infarction (NSTEMI) within a 6 month period. Initial coronary angiography showed two-vessel disease, and percutaneous coronary intervention (PCI) was performed on the left anterior descending artery (LAD). Six months later, repeat angiography revealed rapid progression to three-vessel disease, including in-stent restenosis and new severe lesions, which required urgent coronary artery bypass grafting (CABG). Laboratory tests indicated persistent leukocytosis, with white blood cell (WBC) counts increasing from 38.6 × 10(3)/μL to 75.7 × 10(3)/μL. This case highlights a rare but clinically significant association between CLL and accelerated coronary artery disease (CAD), suggesting potential mechanisms such as leukocyte aggregation, endothelial injury, and amyloid deposition contributing to rapid atherosclerosis. The findings underscore the importance of thorough cardiac evaluation in CLL patients and the need for further research into the underlying mechanisms and optimal treatment strategies for this high-risk group.