Do Factor V Leiden and Prothrombin G20210A Mutations Predict Recurrent Venous Thromboembolism in Older Patients?

Details

Serval ID
serval:BIB_9AAA24EFA8D4
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Do Factor V Leiden and Prothrombin G20210A Mutations Predict Recurrent Venous Thromboembolism in Older Patients?
Journal
The American journal of medicine
Author(s)
Méan M., Limacher A., Stalder O., Angelillo-Scherrer A., Alberio L., Fontana P., Beer H.J., Rodondi N., Lämmle B., Aujesky D.
ISSN
1555-7162 (Electronic)
ISSN-L
0002-9343
Publication state
Published
Issued date
10/2017
Peer-reviewed
Oui
Volume
130
Number
10
Pages
1220.e17-1220.e22
Language
english
Notes
Publication types: Journal Article ; Multicenter Study
Publication Status: ppublish
Abstract
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.
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.
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.
Our results suggest that testing for genetic thrombophilia may not be beneficial in elderly patients with a first unprovoked venous thromboembolism.

Keywords
Aged, Aged, 80 and over, Factor V/genetics, Female, Humans, Male, Mutation/genetics, Prospective Studies, Prothrombin/genetics, Recurrence, Risk Factors, Thrombophilia/complications, Thrombophilia/genetics, Venous Thromboembolism/etiology, Venous Thromboembolism/genetics, Elderly, Recurrent venous thromboembolism, Thrombophilia
Pubmed
Web of science
Create date
22/06/2017 16:56
Last modification date
20/08/2019 15:01
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