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Cerebral Venous Sinus Thrombosis and Acute Myocardial Infarction in a Patient with PAI-1 4G/4G Homozygosity

Daniel Chiu1, Jesse Weinberger2

  • 1Department of Neurology, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, Box 1137, New York, NY 10029; Department of Neurology, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY 10029.

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
|October 17, 2020
PubMed

The plasminogen activator inhibitor-1 (PAI-1) 4G/4G homozygous genotype represents a genetic thrombophilia that has been associated with enhanced risk of arterial and venous thrombotic events. The optimal anticoagulation strategy for PAI-1 4G homozygous patients is unclear. Herein we present a case of a patient with PAI-1 4G/4G homozygosity who was placed on dabigatran after developing cerebral venous sinus thrombosis (CVST), but who then suffered an acute myocardial infarction several weeks later. We seek to highlight the relationship between the PAI-1 4G/4G genotype and risk of CVST, as well as discuss our management strategy in the aftermath of dabigatran failure.

Keywords:
AnticoagulantsDabigatranIntracranialPlasminogen InactivatorsSinus ThrombosisThrombophilia

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