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Thrombin generation and activated protein C resistance in the absence of factor V Leiden correlates with the risk of recurrent venous thromboembolism in women aged 18-65 years.
Thromb Haemost. 2011 Nov; 106(5):901-7.TH

Abstract

Identification of patients at high risk of recurrence after a first event of venous thromboembolism (VTE) remains difficult. Resistance to activated protein C (APC) is a known risk factor for VTE, but data on the risk of recurrence is controversial. We wanted to investigate whether APC resistance in the absence of factor V Leiden, determined with global coagulation test such as the thrombin generation assay, could be used as a marker for increased risk of recurrent VTE among women 18-65 years old after a first event of VTE. In a cohort of 243 women with a first event of VTE, plasma was collected after discontinuation of anticoagulant treatment and the patients were followed up for 46 months (median). Thrombin generation was measured via calibrated automated thrombography, at 1 pM and 10 pM of tissue factor (TF). In women without factor V Leiden (n=117), samples were analysed in the absence and in the presence of APC. Increase in ETP (endogenous thrombin potential) and peak height analysed in the presence of APC correlated significantly with higher risk of recurrence. At 1 pM, peak height correlated with increased risk of recurrence. In conclusion, high thrombin generation in the presence of APC, in women after a first event of VTE is indicative for an increased risk of a recurrence. We also found that thrombin generation at low TF (1 pM) is correlated with the risk of recurrence. Our data suggest that APC resistance in the absence of factor V Leiden is a risk factor for recurrent VTE.

Authors+Show Affiliations

Department of Internal Medicine, Hematology, Södersjukhuset, Stockholm, Sweden. kristina.sonnevi@sodersjukhuset.seNo 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

21947267

Citation

Sonnevi, K, et al. "Thrombin Generation and Activated Protein C Resistance in the Absence of Factor V Leiden Correlates With the Risk of Recurrent Venous Thromboembolism in Women Aged 18-65 Years." Thrombosis and Haemostasis, vol. 106, no. 5, 2011, pp. 901-7.
Sonnevi K, Tchaikovski SN, Holmström M, et al. Thrombin generation and activated protein C resistance in the absence of factor V Leiden correlates with the risk of recurrent venous thromboembolism in women aged 18-65 years. Thromb Haemost. 2011;106(5):901-7.
Sonnevi, K., Tchaikovski, S. N., Holmström, M., Rosing, J., Bremme, K., & Lärfars, G. (2011). Thrombin generation and activated protein C resistance in the absence of factor V Leiden correlates with the risk of recurrent venous thromboembolism in women aged 18-65 years. Thrombosis and Haemostasis, 106(5), 901-7. https://doi.org/10.1160/TH11-04-0254
Sonnevi K, et al. Thrombin Generation and Activated Protein C Resistance in the Absence of Factor V Leiden Correlates With the Risk of Recurrent Venous Thromboembolism in Women Aged 18-65 Years. Thromb Haemost. 2011;106(5):901-7. PubMed PMID: 21947267.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Thrombin generation and activated protein C resistance in the absence of factor V Leiden correlates with the risk of recurrent venous thromboembolism in women aged 18-65 years. AU - Sonnevi,K, AU - Tchaikovski,S N, AU - Holmström,M, AU - Rosing,J, AU - Bremme,K, AU - Lärfars,G, Y1 - 2011/09/22/ PY - 2011/04/19/received PY - 2011/07/29/accepted PY - 2011/9/28/entrez PY - 2011/9/29/pubmed PY - 2012/3/1/medline SP - 901 EP - 7 JF - Thrombosis and haemostasis JO - Thromb Haemost VL - 106 IS - 5 N2 - Identification of patients at high risk of recurrence after a first event of venous thromboembolism (VTE) remains difficult. Resistance to activated protein C (APC) is a known risk factor for VTE, but data on the risk of recurrence is controversial. We wanted to investigate whether APC resistance in the absence of factor V Leiden, determined with global coagulation test such as the thrombin generation assay, could be used as a marker for increased risk of recurrent VTE among women 18-65 years old after a first event of VTE. In a cohort of 243 women with a first event of VTE, plasma was collected after discontinuation of anticoagulant treatment and the patients were followed up for 46 months (median). Thrombin generation was measured via calibrated automated thrombography, at 1 pM and 10 pM of tissue factor (TF). In women without factor V Leiden (n=117), samples were analysed in the absence and in the presence of APC. Increase in ETP (endogenous thrombin potential) and peak height analysed in the presence of APC correlated significantly with higher risk of recurrence. At 1 pM, peak height correlated with increased risk of recurrence. In conclusion, high thrombin generation in the presence of APC, in women after a first event of VTE is indicative for an increased risk of a recurrence. We also found that thrombin generation at low TF (1 pM) is correlated with the risk of recurrence. Our data suggest that APC resistance in the absence of factor V Leiden is a risk factor for recurrent VTE. SN - 2567-689X UR - https://www.unboundmedicine.com/medline/citation/21947267/Thrombin_generation_and_activated_protein_C_resistance_in_the_absence_of_factor_V_Leiden_correlates_with_the_risk_of_recurrent_venous_thromboembolism_in_women_aged_18_65_years_ L2 - http://www.thieme-connect.com/DOI/DOI?10.1160/TH11-04-0254 DB - PRIME DP - Unbound Medicine ER -