Plasminogen activator inhibitor-1, which is released from blood product transfusions, might be associated with (sub)acute thrombosis after coronary dilatation and stenting: a case report.

We present the case of a 71-year-old man who suffered bleeding complications after coronary dilatation and stenting, necessitating a substantial number of platelet and whole blood transfusions in the following days. Postmortem analysis of plasma samples obtained after the transfusions revealed unexpectedly elevated levels of plasminogen activator inhibitor-1 (PAI-1) antigen and activity associated with a nonmeasurable euglobulin clot lysis time, disclosing extreme hypofibrinolysis, which might facilitate coronary thrombosis. The patient died suddenly on day 6, very likely due to coronary thrombosis. Our case suggests that PAI-1, which is released from platelets in blood product transfusions, might be under certain conditions a risk factor for (sub)acute thrombosis after coronary dilatation and stenting.