Do factor V Leiden and prothrombin G20210A mutations predict recurrent venous thromboembolism in older patients?
| Autor: | Lorenzo Alberio, Marie Méan, Pierre Fontana, Andreas Limacher, Anne Angelillo-Scherrer, Bernhard Lämmle, Drahomir Aujesky, Hans-Jürg Beer, Nicolas Rodondi, Odile Stalder |
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| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Pediatrics Mutation/genetics 030204 cardiovascular system & hematology Thrombophilia Thrombophilia/complications/genetics Gastroenterology 03 medical and health sciences 0302 clinical medicine Recurrence Risk Factors Internal medicine hemic and lymphatic diseases medicine Factor V Leiden Humans Venous Thromboembolism/etiology/genetics Cumulative incidence 030212 general & internal medicine Prospective Studies Prospective cohort study Factor V/genetics 610 Medicine & health Aged ddc:616 Aged 80 and over biology business.industry Factor V General Medicine Venous Thromboembolism social sciences medicine.disease Confidence interval humanities Prothrombin/genetics Mutation biology.protein Prothrombin G20210A Prothrombin Female business 360 Social problems & social services Cohort study |
| Zdroj: | American Journal of Medicine, Vol. 130, No 10 (2017) pp. 1220.e17-1220.e22 |
| ISSN: | 0002-9343 |
| DOI: | 10.7892/boris.101809 |
| Popis: | Background The value of genetic thrombophilia testing in elderly patients with an unprovoked venous thromboembolism is unclear. We assessed whether the Factor V Leiden and the prothrombin G20210A mutation are associated with recurrent venous thromboembolism in elderly patients in a prospective multicenter cohort study. Methods We genotyped the Factor V Leiden and the prothrombin G20210A mutation in 354 consecutive in- and outpatients aged ≥65 years with a first unprovoked venous thromboembolism from 9 Swiss hospitals. Patients and managing physicians were blinded to testing results. The outcome was recurrent symptomatic venous thromboembolism during follow-up. We examined the association between the Factor V Leiden and the prothrombin G20210A mutation and venous thromboembolism recurrence using competing risk regression, adjusting for age, sex, and periods of anticoagulation as a time-varying covariate. Results Overall, 9.0% of patients had a Factor V Leiden and 3.7% had a prothrombin G20210A mutation. At 36 months of follow-up, patients with a Factor V Leiden and a prothrombin G20210A mutation had a cumulative incidence of recurrent venous thromboembolism of 12.9% (95% confidence interval [CI], 5.1%-30.8%) and 18.5% (95% CI, 4.9%-56.5%), respectively, compared with 16.7% (95% CI, 12.5%-22.1%) of patients without mutation ( P = .91 by the log-rank test). After adjustment, neither the Factor V Leiden (sub-hazard ratio 0.98; 95% CI, 0.35-2.77) nor the prothrombin G20210A mutation (sub-hazard ratio 1.15; 95% CI, 0.25-5.19) was associated with recurrent venous thromboembolism. Conclusion Our results suggest that testing for genetic thrombophilia may not be beneficial in elderly patients with a first unprovoked venous thromboembolism. |
| Databáze: | OpenAIRE |
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