40 HEREDITARY THROMBOPHILIAS MEDIATING ARTERIAL THROMBOTIC EVENTS.

In 10 normolipidemic patients with 1 or more myocardial infarctions (MI) 35 in men and > 40 mg/dL in women, and triglycerides (TG) 150%) was present in 4 of 7 (57%) cases vs 0/36 controls ( p = .0003). Of 14 hyperlipidemic patients having an arterial event 150%) vs 0/36 controls ( p = .004), 2 of 11 (18%) had high factor XI (> 150%) vs 0/61 controls ( p = .022), and 5 of 13 (38%) had hypofibrinolytic high PAI-Fx (> 21.1 U/mL) vs 4/61 (7%) controls ( p = .007). In both normo- and hyperlipidemic patients sustaining an arterial thrombotic event before age 45, and especially before age 35, we speculate that heritable thrombophilias (factors VIII, XI, factor V Leiden) or hypofibrinolysis (PAI-Fx) may contribute to endothelial damage or altered hemostatic equilibrium and thus promote arterial thrombotic events. In patients with thrombophilia and/or hypofibrinolysis-mediated arterial thrombotic events before age 45, we speculate that thromboprophylaxis might have value in secondary prevention of subsequent arterial thrombotic events.