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
