Acute Myocardial Infarction in Patients with Hereditary Thrombophilia—A Focus on Factor V Leiden and Prothrombin G20210A

Bădescu, Magda; Butnariu, Lăcrămioara Ionela; Costache, Alexandru Dan; Gheorghe, Liliana; Isac, Petronela Nicoleta Seritean; Ion, Adriana; Leancă, Sabina Andreea; Afrăsânie, Irina; Duca, Stefania-Teodora; Gorduza, Eusebiu Vlad; Costache, Irina Iuliana; Rezuş, Ciprian

doi:10.3390/life13061371

Cited by 2 publications

(1 citation statement)

References 109 publications

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“…Activated protein C (APC), together with its cofactor, protein S, inactivates the activated FV, inhibiting coagulation. A single-point mutation in the FV gene at position 1691G/A causes the creation of an aberrant protein (FV Leiden), leading to a prothrombotic condition due to the enhanced procoagulant role of the activated factor V and the reduced anticoagulant role of factor V [2].…”

Section: Introductionmentioning

confidence: 99%

Challenges of a Patient with Thromboembolism

Oancea,

Maștaleru,

Abdulan

et al. 2023

Reports

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Background: FV Leiden is an autosomal dominant disease, representing one of the most prevalent genetic causes for hereditary thrombophilia manifested by venous thromboembolism. Methods: We report a case of a 30-year-old patient who was admitted for enrollment in phase II cardiac rehabilitation. The cardiovascular disease onset was five years ago when the patient was diagnosed with superficial vein thrombosis, for which anticoagulant treatment was recommended. However, he discontinued the prescribed treatment independently, which resulted in the development of deep vein thrombosis. A screening for risk factors associated with venous thromboembolism was conducted, leading to the identification of a heterozygous mutation of factor V Leiden. Later, the patient was hospitalized for acute coronary syndrome necessitating stent implantation. Following this procedure, the patient started a cardiac rehabilitation program, where the patient received multidisciplinary counseling. Conclusions: At the end of the cardiac rehab, significant improvements were observed in clinical and hemodynamic parameters. Consequently, the patient was advised to continue rehabilitation treatment in the outpatient setting. Also, for patients with suboptimal maintenance of the therapeutic range of INR, the use of apixaban might be considered. Furthermore, the utilization of a reduced dosage of apixaban has demonstrated its effectiveness in preventing further venous thromboembolism.

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Section: Introductionmentioning

confidence: 99%

Challenges of a Patient with Thromboembolism

Oancea,

Maștaleru,

Abdulan

et al. 2023

Reports

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Direct oral anticoagulants for deep vein thrombosis among patients with hereditary thrombophilia—A cohort study

Galyfos,

Chamzin,

Charalampopoulos

et al. 2023

Phlebology

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Objectives to evaluate direct oral anticoagulants (DOACs) in patients with hereditary thrombophilia and deep venous thrombosis (DVT). Methods This is a retrospective observational study. Results In total, 45 patients were treated between 01/2012 and 12/2022 (mean follow-up: 1.5 +/− 0.3 years). The most frequent thrombophilias were heterozygous V Leiden (20%), heterozygous MTHFR C677T (37.8%), heterozygous MTHFR A1298C (24.4%), and hyperhomocysteinemia (26.7%). The patients received rivaroxaban ( n = 19), apixaban ( n = 15), and dabigatran ( n = 11). Three cases presented symptoms’ recurrence without evidence of thrombosis’ recurrence (two under rivaroxaban and one under apixaban; p > .05). These patients improved under parenteral anticoagulation and were further treated with dabigatran. No other event or major bleeding occurred during the follow-up. The presence of more than two factors was associated with acute recurrence of symptoms (OR = 25.9; 95% CI [1.454–461.262]; p = .026). Conclusions DOACs seem to be safe and efficient for patients with hereditary thrombophilia and DVT. The presence of more than two thrombophilia factors is associated with a higher risk for symptom recurrence. Although statistically non-significant, symptoms’ recurrence was also observed more frequently among patients under anti-Xa inhibitors than antithrombin inhibitors. This should be verified in larger comparative studies.

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Acute Myocardial Infarction in Patients with Hereditary Thrombophilia—A Focus on Factor V Leiden and Prothrombin G20210A

Cited by 2 publications

References 109 publications

Challenges of a Patient with Thromboembolism

Challenges of a Patient with Thromboembolism

Direct oral anticoagulants for deep vein thrombosis among patients with hereditary thrombophilia—A cohort study

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