Impact of Inherited Prothrombotic Disorders on the Long-Term Clinical Outcome of Percutaneous Transluminal Angioplasty in Patients with Diabetes

Abstract

The aim of our study was to analyse inherited thrombotic disorders that influence the long-term outcome of PTA. Methods. Diabetic patients with peripheral arterial disease (PAD) treated by PTA in our centre between 2008 and 2011 were included in the study. Patients were divided into unsuccessful PTA group (75 patients), successful PTA group (58 patients), and control group (65 patients, with diabetes but no PAD). Diagnosis of inherited thrombotic disorders included mutation in factor V (Leiden), factor II (prothrombin), and mutation in genes for methylenetetrahydrofolate reductase—MTHFR (C677T and A1298C). Results. The genotypic frequency of Leiden allele G1691A was significantly associated with a risk of unsuccessful PTA in comparison with successful PTA group and control group (OR 8.8 (1.1–70.6), p = 0.041, and OR 9.8 (1.2–79.2), p = 0.032, resp.). However, we only observed a trend for the association of the prothrombin allele G20210A and risk of PTA failure. The frequencies of alleles of MTHFR 677 or 1298 did not differ significantly among the groups. Conclusion. Our study showed higher frequency of heterozygous form of Leiden mutation in diabetic patients with unsuccessful outcome of PTA in comparison with patients with successful PTA and diabetic patients without PAD.

Screening for Genetic Variants Suggests β-fibrinogen -455 G/A Genotype as a Contributor to Cardiovascular Complications in Type 2 Diabetes Mellitus

“…Different studies evaluate thrombophilia's gene variants and atherothrombotic and cardiovascular complications. Diabetic patients are affected by abnormalities of the coagulation cascade and are predisposed to thrombotic events because of metabolic changes and acquired or inherited coagulation defects (16). FVL is a procoagulant mutation associated with venous and arterial thrombosis as well as with pregnancy complications.…”

Progressively Worsening Premature Coronary Artery Disease: Adding Anticoagulation Stabilizes–Reverses Clinical Symptomatic Disease Progression in Thrombophilic–Atherothrombotic Patients: A Pilot Study

“…3 Increasingly, it is being realized that thrombophilic procoagulants associated with VTE can also be associated with arterial thrombi. [6][7][8][12][13][14] In young patients (age 50 male or 55 female), particularly with no apparent cause of arterial occlusion, with early cerebral, coronary, and peripheral vascular ischemia, thrombophilia may play a predisposing role. [25][26][27][28] Arterial thrombotic events have been associated with factor V Leiden, prothrombin (G20210A), and MTHFR C677T mutations.…”

“…Moreover, 6 of the 14 atherothrombotic patients with progressively worsening CAD had separately sustained VTE, further testimony to their thrombophilia being associated with both venous and arterial thrombosis. 7,8,[12][13][14]47 In the current pilot study, the otherwise relentless downhill clinical course of CAD could be safely arrested, stabilized, and, in 12 of 14 patients, reversed by anticoagulant therapy in concert with continued maximal medical cardiacsurgical therapy.…”

“…6 Factor V Leiden heterozygosity is more common in diabetic patients with peripheral artery disease who had unsuccessful percutaneous transluminal angioplasty than in those with a successful procedure. 7 Factor V Leiden, prothrombin G20210A, and methylenetetrahydrofolate reductase (MTHFR) C677T mutations increase the risk of myocardial infarction (MI) and ischemic stroke. 8 Given the development of the Xa inhibitors, [9][10][11] combined antiplatelet and anticoagulant therapy, particularly for secondary prevention, is now more commonly being used in patients with atherothrombosis and worsening CAD.…”

Thrombophilia in 153 Patients With Premature Cardiovascular Disease ≤Age 45

“…23 Factor V Leiden heterozygosity is more common in diabetic patients with peripheral artery disease who had unsuccessful percutaneous transluminal angioplasty than in those with a successful procedure. 24 Factor V Leiden, prothrombin G20210A, and MTHFR C677 T mutations increase the risk of myocardial infarction (MI) and ischemic stroke. 5 The link between atherothrombosis and thrombophilia remains a topic of major focus.…”