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Factor V Leiden, prothrombin gene mutation, and thrombosis risk in patients with antiphospholipid antibodies.
J Rheumatol. 2002 Aug; 29(8):1683-8.JR

Abstract

OBJECTIVE

To determine if the prevalence of 2 prothrombotic genetic factors, factor V Leiden and prothrombin gene mutation, is increased in patients with antiphospholipid (aPL) antibodies with a history of venous/arterial thrombosis compared to patients with aPL antibodies with no history of thrombosis.

METHODS

One hundred fifty-seven patients with aPL antibodies were studied. The occurrence of venous and arterial thrombotic events since the time of antibody detection was determined retrospectively, using appropriate clinical and diagnostic criteria. Clinical risk factors for thrombosis were documented and included hypertension, hyperlipidemia, cigarette smoking, diabetes, positive family history, use of oral contraceptive, pregnancy, trauma, hospitalization, varicose veins, and malignancy. Genomic DNA was extracted from blood cells for determination of factor V Leiden mutation G1691 --> A and prothrombin mutation G20210 --> A by polymerase chain reaction and restriction fragment length polymorphism analysis.

RESULTS

Of 157 patients, 69 had a history of thrombosis (venous 37, arterial 32); 147 (94%) patients had anticardiolipin (aCL) antibodies; 69 (45%) had lupus anticoagulant (LAC). The prevalence of factor V Leiden in patients with thrombosis was 13% compared to 4.6% in patients without thrombosis (OR 3.11, CI 0.92-10.6). In patients with aCL antibodies, 15% of patients with arterial thrombosis had factor V mutation compared to 3.5% of patients without thrombosis (OR 4.9, CI 1.2-19.3). The prothrombin gene mutation was identified in 5 patients, none of whom had thrombosis. Stepwise logistic regression analysis indicated that LAC (p = 0.005), male sex (p = 0.04), and hypertension (p = 0.03) were the strongest risk factors for developing thrombosis and that no additional risk was conferred by factor V Leiden (p = 0.13) and prothrombin gene mutation.

CONCLUSION

Although the prevalence of factor V Leiden is modestly increased in patients with autoimmune aPL antibodies and thrombosis, these results suggest that its detection does not significantly increase the risk of a thrombotic event, once other clinical risk factors have been considered. Prothrombin gene mutation is not associated with thrombosis in patients with aPL antibodies.

Authors+Show Affiliations

Division of Rheumatology, Dalhousie University, Halifax, Nova Scotia, Canada.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

12180730

Citation

Chopra, Nikhil, et al. "Factor V Leiden, Prothrombin Gene Mutation, and Thrombosis Risk in Patients With Antiphospholipid Antibodies." The Journal of Rheumatology, vol. 29, no. 8, 2002, pp. 1683-8.
Chopra N, Koren S, Greer WL, et al. Factor V Leiden, prothrombin gene mutation, and thrombosis risk in patients with antiphospholipid antibodies. J Rheumatol. 2002;29(8):1683-8.
Chopra, N., Koren, S., Greer, W. L., Fortin, P. R., Rauch, J., Fortin, I., Senécal, J. L., Docherty, P., & Hanly, J. G. (2002). Factor V Leiden, prothrombin gene mutation, and thrombosis risk in patients with antiphospholipid antibodies. The Journal of Rheumatology, 29(8), 1683-8.
Chopra N, et al. Factor V Leiden, Prothrombin Gene Mutation, and Thrombosis Risk in Patients With Antiphospholipid Antibodies. J Rheumatol. 2002;29(8):1683-8. PubMed PMID: 12180730.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Factor V Leiden, prothrombin gene mutation, and thrombosis risk in patients with antiphospholipid antibodies. AU - Chopra,Nikhil, AU - Koren,Sharon, AU - Greer,Wenda L, AU - Fortin,Paul R, AU - Rauch,Joyce, AU - Fortin,Isabelle, AU - Senécal,Jean-Luc, AU - Docherty,Peter, AU - Hanly,John G, PY - 2002/8/16/pubmed PY - 2003/3/19/medline PY - 2002/8/16/entrez SP - 1683 EP - 8 JF - The Journal of rheumatology JO - J Rheumatol VL - 29 IS - 8 N2 - OBJECTIVE: To determine if the prevalence of 2 prothrombotic genetic factors, factor V Leiden and prothrombin gene mutation, is increased in patients with antiphospholipid (aPL) antibodies with a history of venous/arterial thrombosis compared to patients with aPL antibodies with no history of thrombosis. METHODS: One hundred fifty-seven patients with aPL antibodies were studied. The occurrence of venous and arterial thrombotic events since the time of antibody detection was determined retrospectively, using appropriate clinical and diagnostic criteria. Clinical risk factors for thrombosis were documented and included hypertension, hyperlipidemia, cigarette smoking, diabetes, positive family history, use of oral contraceptive, pregnancy, trauma, hospitalization, varicose veins, and malignancy. Genomic DNA was extracted from blood cells for determination of factor V Leiden mutation G1691 --> A and prothrombin mutation G20210 --> A by polymerase chain reaction and restriction fragment length polymorphism analysis. RESULTS: Of 157 patients, 69 had a history of thrombosis (venous 37, arterial 32); 147 (94%) patients had anticardiolipin (aCL) antibodies; 69 (45%) had lupus anticoagulant (LAC). The prevalence of factor V Leiden in patients with thrombosis was 13% compared to 4.6% in patients without thrombosis (OR 3.11, CI 0.92-10.6). In patients with aCL antibodies, 15% of patients with arterial thrombosis had factor V mutation compared to 3.5% of patients without thrombosis (OR 4.9, CI 1.2-19.3). The prothrombin gene mutation was identified in 5 patients, none of whom had thrombosis. Stepwise logistic regression analysis indicated that LAC (p = 0.005), male sex (p = 0.04), and hypertension (p = 0.03) were the strongest risk factors for developing thrombosis and that no additional risk was conferred by factor V Leiden (p = 0.13) and prothrombin gene mutation. CONCLUSION: Although the prevalence of factor V Leiden is modestly increased in patients with autoimmune aPL antibodies and thrombosis, these results suggest that its detection does not significantly increase the risk of a thrombotic event, once other clinical risk factors have been considered. Prothrombin gene mutation is not associated with thrombosis in patients with aPL antibodies. SN - 0315-162X UR - https://www.unboundmedicine.com/medline/citation/12180730/Factor_V_Leiden_prothrombin_gene_mutation_and_thrombosis_risk_in_patients_with_antiphospholipid_antibodies_ L2 - http://www.jrheum.org/cgi/pmidlookup?view=long&pmid=12180730 DB - PRIME DP - Unbound Medicine ER -