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High risk of cerebral-vein thrombosis in carriers of a prothrombin-gene mutation and in users of oral contraceptives.
N Engl J Med. 1998 Jun 18; 338(25):1793-7.NEJM

Abstract

BACKGROUND

Idiopathic cerebral-vein thrombosis can cause serious neurologic disability. We evaluated risk factors for this disorder, including genetic risk factors (mutations in the genes encoding factor V and prothrombin) and nongenetic risk factors (such as the use of oral contraceptive agents). We compared the prevalence of these risk factors in 40 patients with cerebral-vein thrombosis, 80 patients with deep-vein thrombosis of the lower extremities, and 120 healthy controls. The G1691A mutation in the factor V gene and the G20210A prothrombin-gene mutation, which are established genetic risk factors for venous thrombosis, were studied. We also assessed the use of oral contraceptives and other risk factors for thrombosis.

RESULTS

The prevalence of the prothrombin-gene mutation was higher in patients with cerebral-vein thrombosis (20 percent) than in healthy controls (3 percent; odds ratio, 10.2; 95 percent confidence interval, 2.3 to 31.0) and was similar to that in patients with deep-vein thrombosis (18 percent). Similar results were obtained for the mutation in the factor V gene. The use of oral contraceptives was more frequent among women with cerebral-vein thrombosis (96 percent) than among controls (32 percent; odds ratio, 22.1; 95 percent confidence interval, 5.9 to 84.2) and among those with deep-vein thrombosis (61 percent; odds ratio, 4.4; 95 percent confidence interval, 1.1 to 17.8). For women who were taking oral contraceptives and who also had the prothrombin-gene mutation (seven patients with cerebral-vein thrombosis but only one control), the odds ratio for cerebral-vein thrombosis rose to 149.3 (95 percent confidence interval, 31.0 to 711.0).

CONCLUSIONS

Mutations in the prothrombin gene and the factor V gene are associated with cerebral-vein thrombosis. The use of oral contraceptives is also strongly and independently associated with the disorder. The presence of both the prothrombin-gene mutation and oral-contraceptive use raises the risk of cerebral-vein thrombosis further.

Links

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Authors+Show Affiliations

Martinelli I
Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Istituto di Ricovero e Cura a Carattere Scientifico Maggiore Hospital, University of Milan, Italy.
Sacchi E
No affiliation info available
Landi G
No affiliation info available
Taioli E
No affiliation info available
Duca F
No affiliation info available
Mannucci PM
No affiliation info available

MeSH

AdolescentAdultBlood Coagulation DisordersCase-Control StudiesCerebral VeinsContraceptives, OralFactor VFemaleHeterozygoteHumansIntracranial Embolism and ThrombosisMaleMiddle AgedMutationOdds RatioPrevalenceProthrombinRetrospective StudiesRisk FactorsThrombophlebitis

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

9632445

Citation

Martinelli, I, et al. "High Risk of Cerebral-vein Thrombosis in Carriers of a Prothrombin-gene Mutation and in Users of Oral Contraceptives." The New England Journal of Medicine, vol. 338, no. 25, 1998, pp. 1793-7.
Martinelli I, Sacchi E, Landi G, et al. High risk of cerebral-vein thrombosis in carriers of a prothrombin-gene mutation and in users of oral contraceptives. N Engl J Med. 1998;338(25):1793-7.
Martinelli, I., Sacchi, E., Landi, G., Taioli, E., Duca, F., & Mannucci, P. M. (1998). High risk of cerebral-vein thrombosis in carriers of a prothrombin-gene mutation and in users of oral contraceptives. The New England Journal of Medicine, 338(25), 1793-7.
Martinelli I, et al. High Risk of Cerebral-vein Thrombosis in Carriers of a Prothrombin-gene Mutation and in Users of Oral Contraceptives. N Engl J Med. 1998 Jun 18;338(25):1793-7. PubMed PMID: 9632445.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - High risk of cerebral-vein thrombosis in carriers of a prothrombin-gene mutation and in users of oral contraceptives. AU - Martinelli,I, AU - Sacchi,E, AU - Landi,G, AU - Taioli,E, AU - Duca,F, AU - Mannucci,P M, PY - 1998/6/19/pubmed PY - 1998/6/19/medline PY - 1998/6/19/entrez KW - Biology KW - Blood Coagulation Effects KW - Cerebrovascular Effects KW - Contraception KW - Contraceptive Methods--side effects KW - Correlation Studies KW - Developed Countries KW - Diseases KW - Embolism KW - Europe KW - Family Planning KW - Genetics KW - Hematological Effects KW - Hemic System KW - Italy KW - Mediterranean Countries KW - Oral Contraceptives--side effects KW - Physiology KW - Research Methodology KW - Research Report KW - Risk Factors KW - Southern Europe KW - Statistical Studies KW - Studies KW - Thromboembolism KW - Thrombosis KW - Vascular Diseases SP - 1793 EP - 7 JF - The New England journal of medicine JO - N Engl J Med VL - 338 IS - 25 N2 - BACKGROUND: Idiopathic cerebral-vein thrombosis can cause serious neurologic disability. We evaluated risk factors for this disorder, including genetic risk factors (mutations in the genes encoding factor V and prothrombin) and nongenetic risk factors (such as the use of oral contraceptive agents). We compared the prevalence of these risk factors in 40 patients with cerebral-vein thrombosis, 80 patients with deep-vein thrombosis of the lower extremities, and 120 healthy controls. The G1691A mutation in the factor V gene and the G20210A prothrombin-gene mutation, which are established genetic risk factors for venous thrombosis, were studied. We also assessed the use of oral contraceptives and other risk factors for thrombosis. RESULTS: The prevalence of the prothrombin-gene mutation was higher in patients with cerebral-vein thrombosis (20 percent) than in healthy controls (3 percent; odds ratio, 10.2; 95 percent confidence interval, 2.3 to 31.0) and was similar to that in patients with deep-vein thrombosis (18 percent). Similar results were obtained for the mutation in the factor V gene. The use of oral contraceptives was more frequent among women with cerebral-vein thrombosis (96 percent) than among controls (32 percent; odds ratio, 22.1; 95 percent confidence interval, 5.9 to 84.2) and among those with deep-vein thrombosis (61 percent; odds ratio, 4.4; 95 percent confidence interval, 1.1 to 17.8). For women who were taking oral contraceptives and who also had the prothrombin-gene mutation (seven patients with cerebral-vein thrombosis but only one control), the odds ratio for cerebral-vein thrombosis rose to 149.3 (95 percent confidence interval, 31.0 to 711.0). CONCLUSIONS: Mutations in the prothrombin gene and the factor V gene are associated with cerebral-vein thrombosis. The use of oral contraceptives is also strongly and independently associated with the disorder. The presence of both the prothrombin-gene mutation and oral-contraceptive use raises the risk of cerebral-vein thrombosis further. SN - 0028-4793 UR - https://www.unboundmedicine.com/medline/citation/9632445/High_risk_of_cerebral_vein_thrombosis_in_carriers_of_a_prothrombin_gene_mutation_and_in_users_of_oral_contraceptives_ L2 - https://www.nejm.org/doi/10.1056/NEJM199806183382502?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -