, Volume 8, Issue 6, pp 543-545
Date: 30 Mar 2013

Prothrombotic burden in a patient with recurrent thrombotic events: might an early assessment of thrombophilia be useful in the presence of a strong family history for vascular events?

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Dear Editor,

A 55-year-old man (A. Z.) was admitted to Our Cardiac Step Down Unit of the tertiary center: Careggi Hospital, for an evaluation in the presence of a history of recurrent cardiovascular events.

Classical cardiovascular risk factors:

Hypertension on therapy with a good control, type 2 diabetes mellitus on metformin (3 g/day) with good glycemic control (glycated hemoglobin 5.6 %), high LDL cholesterol levels on statin treatment (rosuvastatin 20 mg/day) reaching a target of LDL 42 mg/dl; low HDL levels (24 mg/dl) on treatment, overweight (BMI 27.6). With regard to family history, almost all his relatives had suffered from a cardiovascular event (Fig. 1) at a young age.Fig. 1

Family tree with clinical and laboratory data

The first thrombotic event occurred at the age of 44 when he had an ischemic stroke without neurological sequelae treated with medical therapy. Aspirin therapy was spontaneously discontinued by the patient after about 4 years.

At the age of 52, he had a STEMI treate ...