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Risk of recurrent venous thrombosis in patients with G20210A mutation in the prothrombin gene or factor V Leiden mutation.
Blood Coagul Fibrinolysis. 2006 Jan; 17(1):23-8.BC

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.

Authors+Show Affiliations

Department of Hematology, University Hospital of Salamanca, Spain. gonzapor@hotmail.comNo 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

Language

eng

PubMed ID

16607075

Citation

González-Porras, José Ramón, et al. "Risk of Recurrent Venous Thrombosis in Patients With G20210A Mutation in the Prothrombin Gene or Factor V Leiden Mutation." Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis, vol. 17, no. 1, 2006, pp. 23-8.
González-Porras JR, García-Sanz R, Alberca I, et al. Risk of recurrent venous thrombosis in patients with G20210A mutation in the prothrombin gene or factor V Leiden mutation. Blood Coagul Fibrinolysis. 2006;17(1):23-8.
González-Porras, J. R., García-Sanz, R., Alberca, I., López, M. L., Balanzategui, A., Gutierrez, O., Lozano, F., & San Miguel, J. (2006). Risk of recurrent venous thrombosis in patients with G20210A mutation in the prothrombin gene or factor V Leiden mutation. Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis, 17(1), 23-8.
González-Porras JR, et al. Risk of Recurrent Venous Thrombosis in Patients With G20210A Mutation in the Prothrombin Gene or Factor V Leiden Mutation. Blood Coagul Fibrinolysis. 2006;17(1):23-8. PubMed PMID: 16607075.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk of recurrent venous thrombosis in patients with G20210A mutation in the prothrombin gene or factor V Leiden mutation. AU - González-Porras,José Ramón, AU - García-Sanz,Ramón, AU - Alberca,Ignacio, AU - López,María Luz, AU - Balanzategui,Ana, AU - Gutierrez,Oliver, AU - Lozano,Francisco, AU - San Miguel,Jesús, PY - 2006/4/12/pubmed PY - 2006/10/28/medline PY - 2006/4/12/entrez SP - 23 EP - 8 JF - Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis JO - Blood Coagul Fibrinolysis VL - 17 IS - 1 N2 - 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. SN - 0957-5235 UR - https://www.unboundmedicine.com/medline/citation/16607075/Risk_of_recurrent_venous_thrombosis_in_patients_with_G20210A_mutation_in_the_prothrombin_gene_or_factor_V_Leiden_mutation_ L2 - https://doi.org/10.1097/01.mbc.0000201488.33143.09 DB - PRIME DP - Unbound Medicine ER -