Recurrent coronary thrombosis, factor V Leiden, primary antiphospholipid syndrome and HIV

We describe a 54-year-old man who was HIV-positive, admitted for cardiogenic shock complications inferior myocardial infarction. He was treated with primary percutaneous transluminal angioplasty (PCTA) and stent deployment in mid right coronary artery. After a few days thrombotic occlusion of the stent occurred, and the problem recurred during implantation of a new stent in the course of a second PTCA. We detected coinheritance of factor V Leiden, primary antiphospholipid syndrome and antithrombin deficiency. We discuss the role of these coagulation disorders in acute myocardial infarction as well as the treatment and course of the coronary syndrome in this context.