Simultaneous subacute coronary drug-eluting stent thrombosis in two different vessels of a patient with factor V

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Published on: August 12, 2014

Parham Eshtehardi1, Masoud Eslami, Davood Akhlagh Moayed

  • 1Cardiovascular Department, Pars General Hospital, Tehran, Iran.

Journal of Cardiovascular Medicine (Hagerstown, Md.)
|March 13, 2008
PubMed

Insights

Factor V Leiden, a common cause of hypercoagulable states, may increase the risk of acute and subacute coronary stent thrombosis in drug-eluting stents. This case highlights the importance of considering genetic thrombophilia in stent thrombosis.

Area of Science:

  • Cardiology
  • Genetics
  • Thrombosis

Background:

  • Drug-eluting stents (DES) are widely used to treat coronary artery disease.
  • Subacute stent thrombosis remains a significant complication, though less common with newer DES generations.
  • Genetic factors influencing hypercoagulability can impact thrombotic risk.

Observation:

  • A 46-year-old man developed cardiogenic shock and myocardial infarction four days after percutaneous coronary intervention with DES.
  • Coronary angiography revealed subacute thrombosis in both the left anterior descending and right coronary artery stents.
  • The patient was identified as a carrier of the factor V Leiden mutation.

Findings:

  • Factor V Leiden is the most common inherited thrombophilia.
  • This genetic mutation confers an increased risk of venous and arterial thrombosis.
  • The presence of factor V Leiden may predispose individuals to acute or subacute stent thrombosis.

Implications:

  • Screening for factor V Leiden may be considered in patients presenting with unexplained stent thrombosis.
  • Understanding genetic predispositions can personalize antithrombotic strategies post-stenting.
  • Further research is warranted to elucidate the precise role of factor V Leiden in DES thrombosis.

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