VENOUS THROMBOSIS DUE TO POOR ANTICOAGULANT RESPONSE TO ACTIVATED PROTEIN-C - LEIDEN THROMBOPHILIA STUDY

被引:1262
作者
KOSTER, T [1 ]
ROSENDAAL, FR [1 ]
DERONDE, H [1 ]
BRIET, E [1 ]
VANDENBROUCKE, JP [1 ]
BERTINA, RM [1 ]
机构
[1] UNIV HOSP LEIDEN, HEMOSTASIS & THROMBOSIS RES CTR, 2300 RC LEIDEN, NETHERLANDS
关键词
D O I
10.1016/S0140-6736(05)80081-9
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
We undertook a population-based case-control study to test the clinical importance of a hereditary abnormality in the coagulation system, characterised by poor anticoagulant response to activated protein C (APC), which is associated with familial thrombophilia. The abnormality was detected in 64 (21%) of 301 unselected consecutive patients younger than 70 years,with a first, objectively confirmed episode of deep-vein thrombosis and without underlying malignant disease. Among 301 healthy control subjects matched for age and sex, the frequency was 5% (14 subjects). Thus, there is a seven-fold increase in risk of deep-vein thrombosis in subjects with a poor response to APC (matched odds ratio 6.6 [95% CI 3.6-12.0]). In addition, there was a clear inverse relation between the degree of response to APC and thrombosis risk. In the families of the patients an autosomal dominant mode of transmission of the abnormality was confirmed. 9 of 10 thrombosis patients with a poor response to APC had 1 parent with a similar poor response, whereas 9 of 10 patients with normal tests had parents with equally normal tests. The abnormality was found in both parents of 1 patient with an extremely poor response to APC; this patient is probably homozygous for the abnormality. We conclude that the poor response to APC is the most important hereditary cause of venous thrombosis. Its high prevalence in a series of unselected patients will make testing of all thrombosis patients for this abnormality worth while.
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收藏
页码:1503 / 1506
页数:4
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