一名PAI-1 4G/4G纯合子患者的脑静脉窦血栓形成与急性心肌梗死

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

作者信息

Chiu Daniel, Weinberger Jesse

机构信息

Department 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.

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

出版信息

J Stroke Cerebrovasc Dis. 2020 Nov;29(11):105250. doi: 10.1016/j.jstrokecerebrovasdis.2020.105250. Epub 2020 Aug 25.

DOI:10.1016/j.jstrokecerebrovasdis.2020.105250

PMID:33066907

Abstract

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.

摘要

纤溶酶原激活物抑制剂-1（PAI-1）4G/4G纯合基因型代表一种遗传性血栓形成倾向，与动脉和静脉血栓形成事件风险增加相关。PAI-1 4G纯合患者的最佳抗凝策略尚不清楚。在此，我们报告一例PAI-1 4G/4G纯合患者，其在发生脑静脉窦血栓形成（CVST）后接受达比加群治疗，但数周后发生急性心肌梗死。我们旨在强调PAI-1 4G/4G基因型与CVST风险之间的关系，并讨论达比加群治疗失败后的管理策略。