Coronary artery disease associated with factor V Leiden mutation: a case report [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. Ahead of Print: TKDA-39939 | DOI: 10.5543/tkda.2018.39939

Coronary artery disease associated with factor V Leiden mutation: a case report

Roberto Muniz Ferreira1, Paolo Blanco Villela1, José Ary Boechat Salles2, João Mansur Filho2
1Edson Saad Heart Institute, Federal University of Rio De Janeiro, Rio De Janeiro, Brasil
2Cardiology Department, Samaritano Hospital, Botafogo, Rio De Janeiro, Brasil

The prevalence of coronary artery disease in young adults (<45 years of age) has been increasing steadily throughout the last decades. Although traditional cardiovascular risk factors can be identified in most cases, newly recognized associations are becoming progressively more relevant. The relationship between factor V Leiden mutation and atherosclerosis has been a matter of debate due to conflicting data in previous studies. We present a case of a previously asymptomatic 37-year-old woman with a significant family history of coronary artery disease, who developed rapidly progressive angina within 1 month. After a positive non-invasive evaluation, coronary angiography demonstrated a significant obstruction in the proximal left anterior descending artery. Optical coherence tomography revealed a highly vulnerable lipid-rich atherosclerotic plaque. Coronary angioplasty followed by 1 drug-eluting stent implantation was successfully performed. A subsequent thrombophilia screening identified a heterozygous factor V R506Q mutation (factor V Leiden). Since there was no history of thromboembolic events, the patient was discharged only using aspirin, clopidogrel, atorvastatin and atenolol. Further studies are needed to define the most appropriate management of young patients who manifest clinically significant atherosclerotic disease in association with hereditary thrombophilia.

Keywords: Coronary artery disease, Young Adult, Thrombophilia

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Corresponding Author: Roberto Muniz Ferreira, Brazil
© Copyright 2019 Archives of the Turkish Society of Cardiology
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