Elevated Hemostatic Factor Levels as Potential Risk Factors for Thrombosis

Abstract

Objectives.—To review the state of the art relating to elevated hemostatic factor levels as a potential risk factor for thrombosis, as reflected by the medical literature and the consensus opinion of recognized experts in the field, and to make recommendations for the use of specific measurements of hemostatic factor levels in the assessment of thrombotic risk in individual patients. Data Sources.—Review of the medical literature, primarily from the last 10 years. Data Extraction and Synthesis.—After an initial assessment of the literature, key points were identified. Experts were assigned to do an in-depth review of the literature and to prepare a summary of their findings and recommendations. A draft manuscript was prepared and circulated to every participant in the College of American Pathologists Conference XXXVI: Diagnostic Issues in Thrombophilia prior to the conference. Each of the key points and associated recommendations was then presented for discussion at the conference. Recommendations were accepted if a consensus of the 27 experts attending the conference was reached. The results of the discussion were used to revise the manuscript into its final form. Conclusions.—Consensus was reached on 8 recommendations concerning the use of hemostatic factor levels in the assessment of thrombotic risk in individual patients. Detailed discussion of the rationale for each of these recommendations is presented in the article. This is an evolving area of research. While routine use of factor level measurements is not recommended, improvements in assay methodology and further clinical studies may change these recommendations in the future.

Prothrombotic state in patients with stable COPD: an observational study

“…In prior studies elevated levels of FII, FVIII, FIX and FXI have primarily been associated with an increased risk of VTE [ 24 , 25 ], while elevated levels of fibrinogen, FV and FVII have primarily been associated with an increased risk of CVD [ 26 , 27 ]. Underlying mechanisms leading to increased prevalence of cardiovascular and VTE events in COPD include platelet activation [ 10 ] and the presence of a prothrombotic state [ 11 ].…”

Coagulation factors II, V, VII, IX, X and XI and mortality – a cohort study

“…Similarly, several studies have shown elevated FV, FIX, and FXI levels as a risk factor for VT [ 15 ]. The same coagulation factors, FIX and XI are associated with increased risks of coronary heart disease and ischemic stroke [ 1 , 5 , 6 , 16 , 17 ].…”

“…For arterial thrombosis, such as myocardial infarction and ischemic stroke, coagulation factors such as FVII, tissue factor, FX, and FII appear to be directly linked to ischemia-reperfusion injury to the myocardium and brain [ 14 ]. FVIII is a coagulation factor that is widely associated with increased risk of both venous and arterial thrombosis [ 15 ] and all-cause mortality [ 2 ].…”

Effect of Glucocorticoid Administration in Intravenous Pulses on Selected Parameters of the Coagulation System

“…The risk of thrombosis is related to the level of factor VIII activity [ 10 ]. Koster et al demonstrated that compared to the control group, the adjusted odds ratio for factor VIII >150% was 4.8 fold and comparable to the risk of factor V Leiden heterozygosity [ 11 , 12 ]. In our research, initially elevated factor VIII activity >150% in the study group occurred in 14.58% of patients.…”