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Int J Angiol 2016; 25(05): e139-e141
DOI: 10.1055/s-0035-1555750
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Elevated Factor VIII Levels Associated with Acute Graft Occlusion and Arterial and Venous Thrombosis After Off Pump CABG

Crystal A. Kyaw
1   Department of Cardiovascular and Thoracic Surgery, Hofstra North Shore–Long Island Jewish School of Medicine, Manhasset, New York
,
Pey-Jen Yu
1   Department of Cardiovascular and Thoracic Surgery, Hofstra North Shore–Long Island Jewish School of Medicine, Manhasset, New York
,
Frank Manetta
1   Department of Cardiovascular and Thoracic Surgery, Hofstra North Shore–Long Island Jewish School of Medicine, Manhasset, New York
› Author Affiliations
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Publication History

Publication Date:
31 July 2015 (online)

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Abstract

Factor VIII is a common acute phase reactant and elevated levels confer an increased risk of thrombosis. Such thrombotic events have been documented in the literature, though to a limited extent. We present the case of a 54-year-old man presenting with a non–Q-wave myocardial infarction who was found to have triple vessel disease and subsequently underwent a 4-vessel coronary artery bypass grafting (CABG). Postoperatively, he was found to have multiple occluded vessels, deep vein thromboses, and a cerebrovascular accident (CVA). A hypercoagulability work-up revealed significantly elevated levels of factor VIII at 377% normal, which likely contributed to these thrombotic events. Further exploration is warranted to elucidate causal mechanisms of these thrombotic events, particularly of multiple graft occlusions, and to guide clinical decision making with regards to anticoagulation and stent management.

Keywords

coronary artery disease - post-CABG thrombosis - factor VIII - acute arterial thrombosis
 

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