| Title | Risk of recurrent venous thrombosis in patients with G20210A mutation in the prothrombin gene or factor V Leiden mutation. | | Author(s) | González-Porras JR, García-Sanz R, Alberca I, López ML, Balanzategui A, Gutierrez O, Lozano F, Miguel JS | | Institution | aDepartment of Hematology, University Hospital of Salamanca bDepartment of Hematology, University Hospital ‘Rio Ortega’ of Valladolid cDepartment of Surgery, University Hospital of Salamanca, Spain. | | Source | Blood Coagul Fibrinolysis 2006 Jan; 17(1):23-28. | | Abstract | The impact of the G20210A prothrombin mutation, factor V Leiden and 677T mutation of methylene tetrahydrofalate reductase (MTHFR) in recurrent deep venous thrombosis (DVT) is not so clear. We have prospectively monitored 259 patients following a first episode of DVT in order to determine which factors influence the development of a recurrent event. Several clinical and biological factors together with the genetic polymorphisms of factor V Leiden, G20210A prothrombin and 677T MTHFR were assessed. During a median follow-up of 786 patient-years, 27 patients (14%) developed one objective episode of recurrent venous thrombosis. The carriers of a double defect, homozygous or double heterozygous for factor V Leiden and G20210A, had an increased risk after a first episode of DVT, while patients who were isolated heterozygous for factor V Leiden or G20210 had a risk of recurrent DVT similar to patients who had neither mutation (annual incidence of 12.1, 3.1, 2.9 and 2.8%). The 677T MTHFR mutation alone or combined with hyperhomocysteinemia was not associated with an increased risk of recurrent events. The development of proximal DVT (P = 0.01) and the presence of a double defect (P = 0.01) were the only two risk factors independently associated with a high recurrence ratio in the multivariate analysis. Thus, the annual incidence of DVT recurrence in patients without any of these two risk factors was only 0.6% (95% confidence interval, 0.2-0.9). We have identified a group of patients with DVT but at very low risk of re-thrombosis in whom an extended secondary thromboprophylaxis should be carefully considered. | | Language | ENG | | Pub Type(s) | JOURNAL ARTICLE
| | PubMed ID | 16607075 |
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