Clinical characteristics of patients with factor V Leiden or prothrombin G20210A and a first episode of venous thromboembolism. Findings from the RIETE Registry

Gadelha, Telma; Roldán, Vanessa; Trujillo‐Santos, Javier; Campo, Raquel; Poggio, Renzo; Monreal, Manuel

doi:10.1016/j.thromres.2010.06.019

Cited by 19 publications

(17 citation statements)

References 25 publications

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“…30 Moreover, the time course in our current study between starting TT and development of a thrombotic event, 6 months (median), is comparable to VTE in women receiving HRT, where VTE rates are highest in the first year of treatment and are much more pronounced in women at higher risk for VTE by virtue of thrombophilia. 31 Our finding that 24% of our TT-VTE patients had factor V Leiden heterozygosity versus 12% of our VTE-no TT controls illustrates the importance of the factor V mutation in VTE, 32,33 and its interaction with TT, promoting thrombotic events. The incidence of factor V Leiden heterozygosity in our VTE control group of 111 patients was 12%, comparable to 12.8% in the large RIETE study of 2744 patients, 32 14.5% in 165 patients studied by Leroyer et al, 34 and 14.1% in 99 patients studied by de Moerloose et al, 35 but lower than 19% in 1668 patients studied by Tick et al 36 By promoting VTE in patients with underlying thrombophilia, TT and/or HCG or Clomid therapy may enrich TT-VTE cohorts with more cases of thrombophilia than observed in patients with DVT-PE not taking TT, as in the current study.…”

Section: Discussionmentioning

confidence: 68%

Thrombophilia in 67 Patients With Thrombotic Events After Starting Testosterone Therapy

Glueck

Prince

Patel

et al. 2016

Clin Appl Thromb Hemost

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We compared thrombophilia in 67 cases (59 men and 8 women) with thrombotic events after starting testosterone therapy (TT) versus 111 patient controls having unprovoked venous thrombotic events without TT. In the 67 patients, thrombosis (47 deep venous thrombosis-pulmonary embolism, 16 osteonecrosis, and 4 ocular thrombosis) occurred 6 months (median) after starting TT. Cases differed from controls for factor V Leiden heterozygosity (16 of the 67 [24%] vs 13 [12%] of the 111, P = .038) and for lupus anticoagulant (9 [14%] of the 64 vs 4 [4%] of the 106, P = .019). After a first thrombotic event and continuing TT, 11 cases had a second thrombotic event, despite adequate anticoagulation, 6 of whom, still anticoagulated, had a third thrombosis. Screening for thrombophilia before starting TT should identify men and women at high risk for thrombotic events with an adverse risk-benefit ratio for TT. When TT is given to patients with familial and acquired thrombophilia, thrombosis may occur and recur in thrombophilic men despite anticoagulation.

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Section: Discussionmentioning

confidence: 68%

Thrombophilia in 67 Patients With Thrombotic Events After Starting Testosterone Therapy

Glueck

Prince

Patel

et al. 2016

Clin Appl Thromb Hemost

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“…Finally, as regards FV Leiden, several investigations reported a lower prevalence of FV Leiden in PE in comparison to patients with DVT. [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] In our study, the prevalence of this polymorphism in patients with PE, both with and without DVT, was not significantly different from controls. Moreover, in agreement with previous reports, 3,4,7,8,10,12 the lowest prevalence of FV Leiden was found in patients with isolated PE.…”

Section: Discussionmentioning

confidence: 56%

“…[2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] A similar finding was reported for prothrombin (PT) G20210A polymorphism by some authors, 10,11 but was not confirmed by others. 8,12,13,16,17 Recently, in a large series of patients with a first episode of proximal DVT, Rossi et al 18 found that the risk of symptomatic PE was increased in patients with antithrombin (AT) deficiency or PT G20210A polymorphism and decreased in those with FV Leiden in comparison to patients without inherited thrombophilic defects. Less data are available about the role of other thrombophilic abnormalities, such as the presence of antiphospholipid antibodies (aPL), elevated levels of homocysteine (Hcy), factor VIII (FVIII), or lipoprotein(a) (Lp[a]), in determining the risk of PE.…”

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confidence: 74%

The Thrombophilic Pattern of Different Clinical Manifestations of Venous Thromboembolism: A Survey of 443 Cases of Venous Thromboembolism

Grifoni

Marcucci

Ciuti

et al. 2012

Semin Thromb Hemost

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Although pulmonary embolism (PE) and deep vein thrombosis (DVT) share many risk factors, it is uncertain whether thrombophilic abnormalities may impact differently on the development of these two clinical manifestations of venous thromboembolism (VTE). To give further insight into this issue, we estimated the association of PE with different types of thrombophilia and evaluated whether these abnormalities have a different prevalence in patients presenting with PE, alone or associated with DVT, as compared with those with isolated DVT. In this study 443 consecutive patients with a first episode of VTE and 304 matched healthy controls underwent laboratory screening for thrombophilia, including natural anticoagulants, factor V Leiden and prothrombin G20210A polymorphisms, antiphospholipid antibodies, homocysteine, factor VIII, and lipoprotein(a). Of the 443 patients, 224 patients had isolated DVT, 144 had combined DVT/PE, and 75 had isolated PE. At least one thrombophilic abnormality was detected in 72.8% of DVT, 66% of DVT/EP, and 60% of isolated PE patients. A high prevalence of hyperhomocysteinemia and elevated lipoprotein(a) levels was found in all patients with no significant differences among the three groups. The prevalence of prothrombin G20210A polymorphism and of elevated factor VIII levels was significantly higher in patients with DVT and DVT/PE than in controls, but not in those with isolated PE, whereas factor V Leiden polymorphism was associated with isolated DVT but not with DVT/PE or isolated PE. In conclusion, the thrombophilic burden seems different in isolated PE versus DVT with or without PE, suggesting that PE may encompass a different pathophysiological process of thrombosis to DVT.

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“…In two studies, we compared the clinical characteristics and outcome of patients with a first episode of VTE and factor V Leiden, prothrombin G20210A, or no thrombophilia 17,18. In 2009, 345 patients had factor V Leiden, 261 had prothrombin G20210A, and 2,399 tested negative.…”

Section: Study Supportmentioning

confidence: 99%

VTE Registry: What Can Be Learned from RIETE?

Tzoran¹,

Brenner²,

Papadakis³

et al. 2014

Rambam Maimonides Med J

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The Registro Informatizado de Enfermedad TromboEmbólica (RIETE Registry) is an ongoing, international, prospective registry of consecutive patients with acute venous thromboembolism (VTE) designed to gather and analyze data on treatment patterns and outcomes in patients with acute VTE. It started in Spain in 2001, and 6 years later the database was translated into English with the aim to expand the Registry to other countries. In contrast to randomized controlled trials, there is no imposed experimental intervention: the management is determined solely by physicians. Thus, it provides data on patients with VTE in a real-world situation with an unselected patient population. Data from RIETE are hypothesis-generating and provide feedback from real-world clinical situations. So far, we learned about the natural history of VTE in patients with relative or absolute contraindications to anticoagulant therapy. We also learned interesting aspects on the natural history of VTE, and we built a number of prognostic scores to identify VTE patients at low, moderate, or high risk for adverse outcome.

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Clinical characteristics of patients with factor V Leiden or prothrombin G20210A and a first episode of venous thromboembolism. Findings from the RIETE Registry

Cited by 19 publications

References 25 publications

Thrombophilia in 67 Patients With Thrombotic Events After Starting Testosterone Therapy

Thrombophilia in 67 Patients With Thrombotic Events After Starting Testosterone Therapy

The Thrombophilic Pattern of Different Clinical Manifestations of Venous Thromboembolism: A Survey of 443 Cases of Venous Thromboembolism

VTE Registry: What Can Be Learned from RIETE?

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