Hubert Arnaud, Guéret Pierre, Leurent Guillaume, Martins Raphael P, Auffret Vincent, Bedossa Marc
Centre Hospitalier Universitaire (CHU) de Rennes, Service de Cardiologie et Maladies Vasculaires, Rennes, France; Université de Rennes 1, Laboratoire Traitement du Signal et de l'Image (LTSI), Rennes, France; Institut National de la Santé et de la Recherche Médicale (Inserm), Rennes, France.
Centre Hospitalier Universitaire (CHU) de Rennes, Laboratoire d'Hématologie-Hémostase, Rennes, France.
Rev Port Cardiol (Engl Ed). 2018 Jan;37(1):89.e1-89.e4. doi: 10.1016/j.repc.2016.12.018. Epub 2017 Dec 15.
Protein C deficiency is a coagulation cascade disorder often resulting in venous thromboembolic events but is also a possible contributor to arterial thrombosis. To date, approximately ten cases of myocardial infarction (MI) due to protein C deficiency have been reported in the literature. However, affirming this mechanism requires ruling out the most common causes of MI, i.e. the rupture or erosion of an atherosclerotic plaque. Intravascular imaging of coronary arteries can be of help to identify angiographically undetected atherosclerosis. We report a case of an ST-segment elevation myocardial infarction (STEMI) in a young man with apparent evidence of arterial thrombosis resulting from protein C deficiency and heterozygous factor Leiden mutation which was contradicted by intravascular imaging demonstrating atherosclerosis.
蛋白C缺乏是一种凝血级联紊乱，常导致静脉血栓栓塞事件，但也可能是动脉血栓形成的一个因素。迄今为止，文献中已报道了约10例因蛋白C缺乏导致的心肌梗死（MI）病例。然而，要证实这一机制，需要排除MI最常见的原因，即动脉粥样硬化斑块破裂或糜烂。冠状动脉血管内成像有助于识别血管造影未发现的动脉粥样硬化。我们报告一例年轻男性的ST段抬高型心肌梗死（STEMI），该患者有蛋白C缺乏和杂合子莱顿因子突变导致动脉血栓形成的明显证据，但血管内成像显示为动脉粥样硬化，与之矛盾。
