Outcome of Patients with Venous Thromboembolism and Factor V Leiden or Prothrombin 20210 Carrier Mutations During the Course of Anticoagulation.
Details
Serval ID
serval:BIB_37674A254CDD
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Outcome of Patients with Venous Thromboembolism and Factor V Leiden or Prothrombin 20210 Carrier Mutations During the Course of Anticoagulation.
Journal
The American journal of medicine
Working group(s)
Registro Informatizado de Enfermedad TromboEmbólica Investigators
Contributor(s)
Decousus H., Prandoni P., Brenner B., Barba R., Di Micco P., Bertoletti L., Tzoran I., Reis A., Bosevski M., Bounameaux H., Malý R., Wells P., Papadakis M., Adarraga M.D., Aibar M.A., Alfonso M., Arcelus J.I., Barba R., Barrón M., Barrón-Andrés B., Bascuñana J., Blanco-Molina A., Bueso T., Cañada G., Cañas I., Chic N., Del Pozo R., Del Toro J., Díaz-Pedroche M.C., Díaz-Peromingo J.A., Falgá C., Fernández-Capitán C., Fidalgo M.A., Font C., Font L., Gallego P., García A., García M.A., García-Bragado F., García-Brotons P., Gavín O., Gómez C., Gómez V., González J., González-Marcano D., Grau E., Grimón A., Guijarro R., Gutiérrez J., Hernández-Comes G., Hernández-Blasco L., Hermosa-Los Arcos M.J., Jara-Palomares L., Jaras M.J., Jiménez D., Joya M.D., Llamas P., Lecumberri R., Lobo J.L., López P., López-Jiménez L., López-Reyes R., López-Sáez J.B., Lorente M.A., Lorenzo A., Maestre A., Marchena P.J., Martín-Martos F., Monreal M., Nieto J.A., Nieto S., Núñez A., Núñez M.J., Odriozola M., Otero R., Pedrajas J.M., Pérez G., Pérez-Ductor C., Peris M.L., Porras J.A., Reig O., Riera-Mestre A., Riesco D., Rivas A., Rodríguez C., Rodríguez-Dávila M.A., Rosa V., Ruiz-Giménez N., Sahuquillo J.C., Sala-Sainz M.C., Sampériz A., Sánchez-Martínez R., Sánchez Simón-Talero R., Sanz O., Soler S., Suriñach J.M., Torres M.I., Trujillo-Santos J., Uresandi F., Valero B., Valle R., Vela J., Vicente M.P., Villalobos A., Vanassche T., Verhamme P., Wells P., Hirmerova J., Malý R., Tomko T., Del Pozo G., Salgado E., Sánchez G.T., Bertoletti L., Bura-Riviere A., Mahé I., Merah A., Moustafa F., Papadakis M., Braester A., Brenner B., Tzoran I., Antonucci G., Barillari G., Bilora F., Bortoluzzi C., Cattabiani C., Ciammaichella M., Di Biase J., Di Micco P., Duce R., Ferrazzi P., Giorgi-Pierfranceschi M., Grandone E., Imbalzano E., Lodigiani C., Maida R., Mastroiacovo D., Pace F., Pesavento R., Pinelli M., Poggio R., Prandoni P., Rota L., Tiraferri E., Tonello D., Tufano A., Visonà A., Zalunardo B., Gibietis V., Skride A., Vitola B., Monteiro P., Ribeiro J.L., Sousa M.S., Bosevski M., Zdraveska M., Bounameaux H., Calanca L., Erdmann A., Mazzolai L.
ISSN
1555-7162 (Electronic)
ISSN-L
0002-9343
Publication state
Published
Issued date
04/2017
Peer-reviewed
Oui
Volume
130
Number
4
Pages
482.e1-482.e9
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Publication Status: ppublish
Abstract
Individuals with factor V Leiden or prothrombin G20210A mutations are at a higher risk to develop venous thromboembolism. However, the influence of these polymorphisms on patient outcome during anticoagulant therapy has not been consistently explored.
We used the Registro Informatizado de Enfermedad TromboEmbólica database to compare rates of venous thromboembolism recurrence and bleeding events occurring during the anticoagulation course in factor V Leiden carriers, prothrombin mutation carriers, and noncarriers.
Between March 2001 and December 2015, 10,139 patients underwent thrombophilia testing. Of these, 1384 were factor V Leiden carriers, 1115 were prothrombin mutation carriers, and 7640 were noncarriers. During the anticoagulation course, 160 patients developed recurrent deep vein thrombosis and 94 patients developed pulmonary embolism (16 died); 154 patients had major bleeding (10 died), and 291 patients had nonmajor bleeding. On multivariable analysis, factor V Leiden carriers had a similar rate of venous thromboembolism recurrence (adjusted hazard ratio [HR], 1.16; 95% confidence interval [CI], 0.82-1.64), half the rate of major bleeding (adjusted HR, 0.50; 95% CI, 0.25-0.99) and a nonsignificantly lower rate of nonmajor bleeding (adjusted HR, 0.66; 95% CI, 0.43-1.01) than noncarriers. Prothrombin mutation carriers and noncarriers had a comparable rate of venous thromboembolism recurrence (adjusted HR, 1.00; 95% CI, 0.68-1.48), major bleeding (adjusted HR, 0.75; 95% CI, 0.42-1.34), and nonmajor bleeding events (adjusted HR, 1.10; 95% CI, 0.77-1.57).
During the anticoagulation course, factor V Leiden carriers had a similar risk for venous thromboembolism recurrence and half the risk for major bleeding compared with noncarriers. This finding may contribute to decision-making regarding anticoagulation duration in selected factor V Leiden carriers with venous thromboembolism.
We used the Registro Informatizado de Enfermedad TromboEmbólica database to compare rates of venous thromboembolism recurrence and bleeding events occurring during the anticoagulation course in factor V Leiden carriers, prothrombin mutation carriers, and noncarriers.
Between March 2001 and December 2015, 10,139 patients underwent thrombophilia testing. Of these, 1384 were factor V Leiden carriers, 1115 were prothrombin mutation carriers, and 7640 were noncarriers. During the anticoagulation course, 160 patients developed recurrent deep vein thrombosis and 94 patients developed pulmonary embolism (16 died); 154 patients had major bleeding (10 died), and 291 patients had nonmajor bleeding. On multivariable analysis, factor V Leiden carriers had a similar rate of venous thromboembolism recurrence (adjusted hazard ratio [HR], 1.16; 95% confidence interval [CI], 0.82-1.64), half the rate of major bleeding (adjusted HR, 0.50; 95% CI, 0.25-0.99) and a nonsignificantly lower rate of nonmajor bleeding (adjusted HR, 0.66; 95% CI, 0.43-1.01) than noncarriers. Prothrombin mutation carriers and noncarriers had a comparable rate of venous thromboembolism recurrence (adjusted HR, 1.00; 95% CI, 0.68-1.48), major bleeding (adjusted HR, 0.75; 95% CI, 0.42-1.34), and nonmajor bleeding events (adjusted HR, 1.10; 95% CI, 0.77-1.57).
During the anticoagulation course, factor V Leiden carriers had a similar risk for venous thromboembolism recurrence and half the risk for major bleeding compared with noncarriers. This finding may contribute to decision-making regarding anticoagulation duration in selected factor V Leiden carriers with venous thromboembolism.
Keywords
Activated Protein C Resistance/complications, Anticoagulants/therapeutic use, Factor V/genetics, Female, Hemorrhage/chemically induced, Hemorrhage/etiology, Hemorrhage/genetics, Heterozygote, Humans, Male, Middle Aged, Mutation/genetics, Prothrombin/genetics, Risk Factors, Treatment Outcome, Venous Thromboembolism/drug therapy, Venous Thromboembolism/genetics, Anticoagulant therapy, Bleeding, Thrombophilia, Venous thromboembolism
Pubmed
Web of science
Create date
12/10/2018 13:50
Last modification date
20/08/2019 14:25
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