Increased plasma levels of lipoprotein(a) and the risk of idiopathic and recurrent venous thromboembolism

Marcucci, Rossella; Liotta, Agatina Alessandrello; Cellai, Anna Paola; Rogolino, Angela; Gori, Anna Maria; Giusti, Betti; Poli, Daniela; Fedi, Stefano; Abbate, Rosanna; Prisco, Domenico

doi:10.1016/j.amjmed.2003.06.005

Cited by 88 publications

(68 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In this study, thrombophilias associated with venous disease (e.g., factor V Leiden and prothrombin gene mutation) as well as those associated with both venous and arterial disease (e.g., lipoprotein [a] [43,44] and homocysteine [34,45]) were evaluated. In the general population, thrombophilias associated with venous thrombosis are often treated with oral anticoagulants.…”

Section: Discussionmentioning

confidence: 99%

Thrombophilia and the Risk for Hemodialysis Vascular Access Thrombosis

Knoll¹,

Wells²,

Young³

et al. 2005

Journal of the American Society of Nephrology

View full text Add to dashboard Cite

Vascular access thrombosis is the most common and costly complication in hemodialysis patients. The role of thrombophilia in access thrombosis is not established. A case-control study was conducted of 419 hemodialysis patients to determine whether thrombophilia was associated with arteriovenous fistula or graft thrombosis. Participants were enrolled from three in-center and five satellite dialysis units associated with a Canadian academic health science center that provides dialysis services in a catchment area of one million. Patients were tested for factor V Leiden, prothrombin gene mutation, factor XIII genotype, methylenetetrahydrofolate reductase genotype, lupus anticoagulant, anticardiolipin antibody, factor VIII, homocysteine, and lipoprotein (a) concentrations. Overall, 59 (55%) patients with access thrombosis had at least one thrombophilia compared with 122 (39%) patients without access thrombosis (unadjusted odds ratio [OR], 1.91; 95% confidence interval [CI], 1.23 to 2.98). After controlling for important risk factors, the association between any thrombophilia and access thrombosis remained (adjusted OR, 2.42; 95% CI, 1.47 to 3.99). For each additional thrombophilic disorder, the odds of access thrombosis increased significantly (adjusted OR, 1.87; 95% CI, 1.34 to 2.61). This study suggests that thrombophilia is associated with access thrombosis in dialysis patients. Large, multicenter, prospective cohort studies are needed to confirm the observations from this case-control study.

show abstract

Section: Discussionmentioning

confidence: 99%

Thrombophilia and the Risk for Hemodialysis Vascular Access Thrombosis

Knoll¹,

Wells²,

Young³

et al. 2005

Journal of the American Society of Nephrology

View full text Add to dashboard Cite

show abstract

“…After carefully examining the full text of the remaining 22 articles, 11 were excluded because of the following reasons: (i) lack of prospective design; [10][11][12][13][14][15][16] (ii) inclusion of patients with recurrent VTE as index event without providing separate information for those with a first event;…”

Section: Selection Of Studiesmentioning

confidence: 99%

“…34 They included a substantial proportion of retrospective studies. 13,14,16 These have a higher potential for biases including patient selection, differences in treatment exposures, and inadequate identification of recurrent thrombotic disease. 6 Although their findings were confirmed even when the analysis was confined to prospective studies, they could not include two studies that were published later on.…”

mentioning

confidence: 99%

The risk of recurrent venous thromboembolism among heterozygous carriers of factor V Leiden or prothrombin G20210A mutation. A systematic review of prospective studies

Marchiori¹,

Mosena²,

Prins³

et al. 2007

Haematologica

160

104

View full text Add to dashboard Cite

Factor V Leiden (FVL) and prothrombin G20210A mutation (PTM) are the two most common genetic polymorphisms known to predispose to a first episode of venous thromboembolism (VTE). However, whether these thrombophilic abnormalities are also risk factors for recurrent VTE is unclear. We conducted a systematic review of prospective studies to assess the risk of recurrent VTE associated with heterozygous carriage of each of these mutations. All randomized controlled trials and prospective cohort studies that reported the incidence of recurrent VTE in patients with and without FVL and PTM after discontinuation of anticoagulant treatment were collected and analyzed. The risk ratios (RR) and their 95% confidence intervals (CI) for recurrent VTE were calculated in heterozygous carriers of FVL or PTM and compared to those of noncarriers. Eleven studies fulfilled the inclusion criteria. Recurrent VTE occurred in 114 out of 557 heterozygous carriers of FVL (20.5%) as compared to 382 out of 2,646 non-carriers (14.4%); and in 38 out of 212 heterozygous carriers of PTM (17.9%) compared to 428 of 2,996 non-carriers (14.3%). The RR of VTE recurrence conferred by the heterozygous carriage of FVL and PTM was 1.39 (95% CI, range 1.15 to 1.67) and 1.20 (range 0.89 to 1.61), respectively, using the Mantel-Haenszel fixed-effects model; 1.45 (1.13 to 1.85) and 1.36 (1.02 to 1.82), respectively, using the Der Simonian and Laird random effects method. In symptomatic patients with VTE, heterozygous carriage of FVL is clearly associated with a definitely increased risk of recurrent thromboembolism. The risk is lower with PTM and is difficult to interpret since it varies according to the assessment method used.Key words: venous thromboembolism, thrombophilia, anticoagulation, factor V Leiden, prothrombin G20210A. ollowing the discovery of factor V Leiden (FVL) and prothrombin G20210A mutation (PTM) in the first half of the 1990s, numerous case-control, cross-sectional, and family studies have provided the convincing evidence that heterozygosity for either mutation is associated with a significantly increased risk of venous thromboembolism (VTE).1-3 This risk is higher in homozygous carriers and in carriers of double heterozygosity. While it is widely acknowledged that these mutations confer an increased risk of thrombosis, it is controversial whether patients who are heterozygous carriers of either mutation and develop a thrombotic episode have an increased risk of recurrent events in comparison with non-carriers.1-3 As a consequence, it is still not known whether detection of these abnormalities, which are highly prevalent in western countries, has the potential to identify a subgroup of patients who might benefit from the adoption of individually adjusted prevention strategies following their first thrombotic episode.4,5 Available literature dealing with this issue includes both prospective and retrospective investigations. By definition, prospective studies are methodologically stronger, as they imply the formation of an appropriate inc...

show abstract

“…Lp(a) might also propagate atherothrombosis by inhibiting platelet-mediated fibrinolysis and modulating platelet activation and aggregation [39]. It has also been found that Lp(a) may constitute an independent risk factor for venous thromboembolism [40]. There is a data that Lp(a) inhibits the production of tissue-type plasminogen activator (tPA) [41] and stimulate the synthesis of plasminogen activator inhibitor-1 (PAI-1) [42].…”

Section: Role Of Lipoprotein (A) In the Pathogene-sis Of Atherothrombmentioning

confidence: 99%

Lipoprotein (a) and Stroke: An Overview~!2009-10-29~!2009-12-27~!2010-04-08~!

Christogiannis¹,

Milionis²,

Elisaf³

2012

TOCCHEMJ

View full text Add to dashboard Cite

Stroke remains a major cause of mortality and long term severe disability worldwide. Lipoprotein (a) [Lp(a)] is a predictor of many forms of vascular disease, and may serve as a tool in identifying subjects at risk. Despite accumulating evidence from cross sectional and prospective studies, its role in the development of stroke is still in doubt. Methodological issues regarding measurement remain to be resolved. Whether reductions in Lp(a) levels will result in a reduction of vascular events, including stroke, remains to be established. Aggressive management of established cardiovascular risk factors is advocated in subjects exhibiting elevated serum Lp(a) concentrations.

show abstract

Increased plasma levels of lipoprotein(a) and the risk of idiopathic and recurrent venous thromboembolism

Cited by 88 publications

References 33 publications

Thrombophilia and the Risk for Hemodialysis Vascular Access Thrombosis

Thrombophilia and the Risk for Hemodialysis Vascular Access Thrombosis

The risk of recurrent venous thromboembolism among heterozygous carriers of factor V Leiden or prothrombin G20210A mutation. A systematic review of prospective studies

Lipoprotein (a) and Stroke: An Overview~!2009-10-29~!2009-12-27~!2010-04-08~!

Contact Info

Product

Resources

About