Prevalence of common thrombophilia markers and risk factors in Indian patients with primary venous thrombosis

Abstract

CONTEXT AND OBJECTIVE: Venous thrombosis occurs as a result of interaction of genetic and acquired factors including activated protein C resistance (APC-R), fibrinogen levels, antithrombin, protein C, protein S, lupus anticoagulants and anticardiolipin antibodies. This study was aimed at determining the prevalence of these common thrombophilia markers in Asian Indians with primary venous thrombosis. DESIGN AND SETTING: This was a cross-sectional study carried out in Mumbai. METHODS: Samples from 78 patients with a confirmed diagnosis of venous thrombosis and 50 controls were tested. Semi-quantitative estimation (functional assays) of protein C, protein S and antithrombin was performed. Quantitative estimation of fibrinogen was done using the Clauss method. Lupus anticoagulants were screened using lupus-sensitive activated partial thromboplastin time and β2-glycoprotein-I dependent anticardiolipin antibodies were estimated by ELISA. APC-R was measured using a clotting-based method with factor V deficient plasma and Crotalus viridis venom. Statistical analysis was performed using Epi-info (version 6). RESULTS: The popliteal vein was the most commonly involved site. Forty-four samples (56%) gave abnormal results. The commonest were elevated fibrinogen and APC-R (17.9% each), followed by low protein S (16.6%). CONCLUSIONS: This study confirms the literature findings that fibrinogen level estimation and screening for APC-R are important for the work-up on venous thrombosis patients since these, singly or in combination, may lead to a primary thrombotic episode. The frequency of the other thrombophilia markers was higher among the patients than among the controls, but without statistically significant difference.

Clinical profile, common thrombophilia markers and risk factors in 85 young Indian patients with arterial thrombosis

“…AT estimation was done on a biochemistry analyzer, as mentioned in a previous study on venous thrombosis. 7 The diagnostic methods for detecting MI were troponin T, CK MB and aminotransferase; EKG or echocardiography during acute phase of MI followed by coronary angiography; radionuclide lung scanning or angiography for pulmonary embolism; arteriography for peripheral arterial occlusions; and CT scan, magnetic resonance imaging or arteriography for cerebral thrombosis. For a diagnosis of transient ischemic attack (TIA), a focal neurological deficit resolving within 24 hours was required, whereas if it persisted beyond 24 hours, a diagnosis of stroke was made.…”

Common thrombophilia markers in young patients with primary arterial and venous thrombosis

“…In a study conducted by Mishra et al a similar average age for first thrombotic event was found to be 36 years. 4 An association was found between low levels of protein C or S or resistance to factor V and the thrombotic event.…”

Role of low dose ecosprin and heparin in achieving live births in pregnancy with thrombophilia

“…It is this hypercoaguable condition that paves way to thrombotic events more often in pregnant population than in general population resulting in adverse outcomes like abortions or recurrent abortions, intraurine growth restriction, intrauterine fetal demise, placental abruption and preeclampsia. [1][2][3][4][5][6][7][8][9][10][11][12][13] Hence, the evaluation and management of thrombophilia is imperative in women who have history of fetal loss/losses or adverse pregnancy outcomes.…”

“…The thrombotic events are not only restricted to venous thromboembolism but also can cause fetal loss (abortions or recurrent abortions and fetal demise), placental abruption, intrauterine growth restriction and severe preeclampsia. [1][2][3][4][5][6][7][8][9][10][11][12][13] In the recent years various studies have evaluated the role of administering thromboprophylaxis to patients with previous history of adverse obstetric outcomes who have tested positive for inherited and acquired thrombophilia. 11,[14][15][16][17] This study adds to the existing data base discerning the role of thromboprophylaxis with heparin and ecosprin in patients with thrombophilia in pregnancy.…”