High Plasma Levels of Factor VIII and the Risk of Recurrent Venous Thromboembolism

Kyrle, Paul A.; Minar, Erich; Hirschl, Mirko; Bialonczyk, Christine; Stain, Milena; Schneider, Barbara; Weltermann, Ansgar; Speiser, Wolfgang; Lechner, Klaus; Eichinger, Sabine

doi:10.1056/nejm200008173430702

Cited by 691 publications

(522 citation statements)

References 26 publications

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“…Moreover, during the entire follow-up period, only 58 thrombotic recurrences (Ϸ9.7% of patients) were recorded; this figure is lower than might be expected, although it is similar to those reported in other studies. 23 An Italian collaborative study showed that no long-term clinical benefit was associated with extending the 3-month course of anticoagulant treatment to 1 year in patients with idiopathic proximal DVT. In fact, prolongation of anticoagulation only delays recurrences until anticoagulation is stopped and does not reduce the risk of recurrence.…”

Section: Palareti Et Al D-dimer and Vte Recurrence 315mentioning

confidence: 99%

Predictive Value of D-Dimer Test for Recurrent Venous Thromboembolism After Anticoagulation Withdrawal in Subjects With a Previous Idiopathic Event and in Carriers of Congenital Thrombophilia

et al. 2003

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Background-We have shown that normal D-dimer levels obtained after the discontinuation of oral anticoagulant treatment (OAT) has a high negative predictive value for recurrent venous thromboembolism (VTE). The aim of the present study was to assess the predictive value of D-dimer for recurrent VTE in subjects with a previous unprovoked event who are either carriers of inherited thrombophilia or not. Methods and Results-We prospectively evaluated 599 patients (301 males) with a previous VTE episode. They were repeatedly examined for D-dimer levels after OAT withdrawal and were screened for inherited thrombophilic alterations. Alterations were detected in 130 patients (21.7%), factor V Leiden (70 patients; 2 of whom were homozygotes) and prothrombin mutation (38 patients) were the most prevalent ones. Recurrent events were recorded in 58 subjects (9.7%) during a follow-up of 870.7 patient-years. Altered D-dimer levels at 1 month after OAT withdrawal were associated with a higher rate of subsequent recurrence in all subjects investigated, especially in those with an unprovoked qualifying VTE event (hazard ratio, 2.43; 95% confidence interval, 1.18 to 4.61) and in those with thrombophilia (hazard ratio, 8.34; 95% confidence interval, 2.72 to 17.43). The higher relative risk for recurrence of altered D-dimer was confirmed by multivariate analysis after adjustment for other risk factors. The negative predictive value of D-dimer was 92.9% and 95.8% in subjects with an unprovoked qualifying event or with thrombophilia, respectively. Conclusions-D-dimer levels measured 1 month after OAT withdrawal have a high negative predictive value for recurrence in subjects with unprovoked VTE who are either carriers or not carriers of congenital thrombophilia.

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Section: Palareti Et Al D-dimer and Vte Recurrence 315mentioning

confidence: 99%

Predictive Value of D-Dimer Test for Recurrent Venous Thromboembolism After Anticoagulation Withdrawal in Subjects With a Previous Idiopathic Event and in Carriers of Congenital Thrombophilia

et al. 2003

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“…By preference such a predictor is not influenced by use or type of anticoagulants, optimizing the applicability of the assessment model. Candidate coagulation factors are factor (F)VIII, von Willebrand factor (VWF), and d ‐dimer for which higher levels are associated with increased recurrence risk 3, 4, 5, 6, 7. Preferably, risk assessment and herewith the measurement of these coagulation factors is performed while the patient is still on anticoagulant treatment.…”

Section: Introductionmentioning

confidence: 99%

Measurement of coagulation factors during rivaroxaban and apixaban treatment: Results from two crossover trials

Scheres

Lijfering

Cheung

et al. 2018

Research and Practice in Thrombosis and Haemostasis

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BackgroundPrediction models for venous thromboembolism recurrence will likely be improved by adding levels of coagulation factors. Risk assessment is ideally performed during anticoagulant treatment, however, the influence of direct oral anticoagulants on coagulation factors is uncertain.ObjectiveTo assess the influence of rivaroxaban and apixaban on several coagulation factor levels.MethodsIn two crossover trials we assessed the influence of rivaroxaban and apixaban intake on factor (F)VIII, FXI and FXII‐activity and fibrinogen, von Willebrand factor (VWF:Ag), and d‐dimer levels. At three sessions with a washout period in between, blood was taken from 12 healthy male individuals immediately before intake of rivaroxaban 15 mg twice daily (n = 6) or apixaban 10 mg twice daily (n = 6) and three hours after the last intake.ResultsOverall, measured levels were lower after rivaroxaban/apixaban intake. The paired mean difference after rivaroxaban intake was −38 IU/dL (95% CI −43; −33) for FVIII:C, −29 U/dL (95% CI −45; −12) for FXI:C, −22 IU/dL (95% CI −43; −1) for FXII:C, −0.11 g/L (95% CI −0.25; 0.03) for fibrinogen, −7 IU/dL (95% CI −18; 3) for VWF:Ag, −27 ng/mL (95% CI −50; −4) for d‐dimer and −0.36 (95% CI −0.57; −0.15) for Ln d‐dimer. After apixaban intake this was −29 IU/dL (95% CI −38; −21) for FVIII:C, −29 IU/dL (95% CI −36; −22) for FXI:C, −19 IU/dL (95% CI −24; −15) for FXII:C, −0.18 g/L (95% CI −0.33; 0.03) for fibrinogen, −52 ng/mL (95% CI −100; −4) for d‐dimer, 0.25 (−0.60; 0.09) for Ln d‐dimer and 1 IU/dL (95% CI −7; 9) for VWF:Ag.Conclusion FVIII:C, FXI:C, FXII:C, and d‐dimer measurements were influenced by rivaroxaban/apixaban intake, while fibrinogen and VWF:Ag were not.

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“…Elevated levels of coagulation factor (FVIII) are an important risk factor for venous thrombosis [1][2][3][4]. FVIII activity (FVIII:C) ‡150 IU dL )1 increases the risk of a first venous thrombosis 5-fold compared to levels below 100 IU dL )1…”

mentioning

confidence: 99%

Haplotypes encoding the factor VIII 1241Glu variation and the risk of myocardial infarction

Nossent

Eikenboom

Tanis

et al. 2007

Journal of Thrombosis and Haemostasis

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High Plasma Levels of Factor VIII and the Risk of Recurrent Venous Thromboembolism

Abstract: Patients with a high plasma level of factor VIII have an increased risk of recurrent venous thromboembolism.

Cited by 691 publications

References 26 publications

Predictive Value of D-Dimer Test for Recurrent Venous Thromboembolism After Anticoagulation Withdrawal in Subjects With a Previous Idiopathic Event and in Carriers of Congenital Thrombophilia

Predictive Value of D-Dimer Test for Recurrent Venous Thromboembolism After Anticoagulation Withdrawal in Subjects With a Previous Idiopathic Event and in Carriers of Congenital Thrombophilia

Measurement of coagulation factors during rivaroxaban and apixaban treatment: Results from two crossover trials

Haplotypes encoding the factor VIII 1241Glu variation and the risk of myocardial infarction

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