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[Recurrent coronary thrombosis, factor V Leiden, primary antiphospholipid syndrome and HIV]

José L Santos1, Ignacio Cruz, Francisco Martín Herrero

  • 1Servicio de Cardiología, Hospital Universitario de Salamanca, Salamanca, Spain.

Revista Espanola De Cardiologia
|October 8, 2004
PubMed

Insights

A myocardial infarction patient with HIV experienced stent thrombosis due to inherited clotting disorders: factor V Leiden, antiphospholipid syndrome, and antithrombin deficiency. This case highlights the complex interplay of these conditions in cardiovascular events.

Area of Science:

  • Cardiology
  • Hematology
  • Genetics

Background:

  • Coronary artery disease management
  • HIV complications
  • Thrombotic events

Observation:

  • A 54-year-old HIV-positive male presented with cardiogenic shock secondary to inferior myocardial infarction.
  • Initial treatment involved percutaneous transluminal coronary angioplasty (PTCA) with stent deployment in the right coronary artery.
  • Recurrent thrombotic occlusion of the stent necessitated a second PTCA.

Findings:

  • Coinheritance of factor V Leiden, primary antiphospholipid syndrome, and antithrombin deficiency was identified.
  • These coagulation disorders are implicated in the recurrent stent thrombosis and myocardial infarction.
  • The patient's complex thrombotic profile significantly impacted treatment and clinical course.

Implications:

  • Highlights the critical need to investigate underlying thrombophilia in patients with recurrent stent thrombosis, especially in those with comorbidities like HIV.
  • Suggests tailored anticoagulation strategies may be necessary for patients with multiple inherited thrombotic disorders experiencing acute coronary syndromes.
  • Underscores the importance of understanding genetic predispositions in managing cardiovascular complications in diverse patient populations.

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