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Higher prevalence of thrombophilia in patients with varicose veins and venous ulcers than controls.
J Vasc Surg 2009; 49(5):1235-41JV

Abstract

BACKGROUND

Uncontrolled studies suggest that patients with chronic venous ulceration (CVU) have an increased prevalence of thrombophilia, similar to that observed in patients with deep vein thrombosis. This study compared the nature and prevalence of thrombophilia in patients with varicose veins (VV, CEAP clinical [C] grade C(2) to C(3)) and patients with CVU (C(5) to C(6)) with an age- and sex-matched population without clinical or duplex ultrasound evidence of venous disease.

METHODS

Twenty-seven patients with VV, 27 patients with CVU, and 54 age- and sex-matched case controls with no clinical or duplex evidence of lower limb venous disease, underwent testing for factor V Leiden and prothrombin 20210A mutations, antithrombin deficiencies, and levels of antiphospholipid antibodies, homocysteine, protein C and S, and factor VIII, IX, and XI.

RESULTS

The overall prevalences of single and multiple thrombophilias were significantly higher in cases than in controls. Specifically, in VV patients, the prevalences of no, single, and multiple thrombophilias were 33%, 52%, and 15%, respectively, compared with 63%, 26%, and 11% in VV controls. In CVU patients, the prevalences of no, single, and multiple thrombophilias was 26%, 30%, and 44%, respectively, compared with 66%, 22%, and 11% in CVU controls. Compared with controls, only factor XI levels were significantly higher in VV patients, and homocysteine and factor VIII, IX, and XI levels were all significantly higher in CVU patients.

CONCLUSION

Patients with VV, and particularly CVU, have significantly higher prevalences of single and multiple thrombophilias than age- and sex-matched controls without clinical or duplex evidence of lower limb venous disease. These data support the hypothesis that thrombophilia predisposes to the development of superficial and deep lower limb venous reflux, and so VV and CVU, through the increased occurrence of clinical and subclinical thrombosis.

Authors+Show Affiliations

Department of Vascular Surgery, Birmingham University, Heart of England NHS Trust, Birmingham, United Kingdom. katydarvall@btinternet.com

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19307088

Citation

Darvall, Katy A L., et al. "Higher Prevalence of Thrombophilia in Patients With Varicose Veins and Venous Ulcers Than Controls." Journal of Vascular Surgery, vol. 49, no. 5, 2009, pp. 1235-41.
Darvall KA, Sam RC, Adam DJ, et al. Higher prevalence of thrombophilia in patients with varicose veins and venous ulcers than controls. J Vasc Surg. 2009;49(5):1235-41.
Darvall, K. A., Sam, R. C., Adam, D. J., Silverman, S. H., Fegan, C. D., & Bradbury, A. W. (2009). Higher prevalence of thrombophilia in patients with varicose veins and venous ulcers than controls. Journal of Vascular Surgery, 49(5), pp. 1235-41. doi:10.1016/j.jvs.2008.12.017.
Darvall KA, et al. Higher Prevalence of Thrombophilia in Patients With Varicose Veins and Venous Ulcers Than Controls. J Vasc Surg. 2009;49(5):1235-41. PubMed PMID: 19307088.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Higher prevalence of thrombophilia in patients with varicose veins and venous ulcers than controls. AU - Darvall,Katy A L, AU - Sam,Rachel C, AU - Adam,Donald J, AU - Silverman,Stanley H, AU - Fegan,Christopher D, AU - Bradbury,Andrew W, PY - 2008/10/21/received PY - 2008/12/09/revised PY - 2008/12/09/accepted PY - 2009/3/25/entrez PY - 2009/3/25/pubmed PY - 2009/5/8/medline SP - 1235 EP - 41 JF - Journal of vascular surgery JO - J. Vasc. Surg. VL - 49 IS - 5 N2 - BACKGROUND: Uncontrolled studies suggest that patients with chronic venous ulceration (CVU) have an increased prevalence of thrombophilia, similar to that observed in patients with deep vein thrombosis. This study compared the nature and prevalence of thrombophilia in patients with varicose veins (VV, CEAP clinical [C] grade C(2) to C(3)) and patients with CVU (C(5) to C(6)) with an age- and sex-matched population without clinical or duplex ultrasound evidence of venous disease. METHODS: Twenty-seven patients with VV, 27 patients with CVU, and 54 age- and sex-matched case controls with no clinical or duplex evidence of lower limb venous disease, underwent testing for factor V Leiden and prothrombin 20210A mutations, antithrombin deficiencies, and levels of antiphospholipid antibodies, homocysteine, protein C and S, and factor VIII, IX, and XI. RESULTS: The overall prevalences of single and multiple thrombophilias were significantly higher in cases than in controls. Specifically, in VV patients, the prevalences of no, single, and multiple thrombophilias were 33%, 52%, and 15%, respectively, compared with 63%, 26%, and 11% in VV controls. In CVU patients, the prevalences of no, single, and multiple thrombophilias was 26%, 30%, and 44%, respectively, compared with 66%, 22%, and 11% in CVU controls. Compared with controls, only factor XI levels were significantly higher in VV patients, and homocysteine and factor VIII, IX, and XI levels were all significantly higher in CVU patients. CONCLUSION: Patients with VV, and particularly CVU, have significantly higher prevalences of single and multiple thrombophilias than age- and sex-matched controls without clinical or duplex evidence of lower limb venous disease. These data support the hypothesis that thrombophilia predisposes to the development of superficial and deep lower limb venous reflux, and so VV and CVU, through the increased occurrence of clinical and subclinical thrombosis. SN - 1097-6809 UR - https://www.unboundmedicine.com/medline/citation/19307088/Higher_prevalence_of_thrombophilia_in_patients_with_varicose_veins_and_venous_ulcers_than_controls_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0741-5214(08)02204-0 DB - PRIME DP - Unbound Medicine ER -