Prevalence and Risk of Thrombophilia Defects in Vascular Patients

Abstract

This paper reviews the available data on the prevalence of thrombophilia defects in patients with peripheral vascular disease (PVD) and attempts to delineate the risk of failure of vascular intervention in these patients. The prevalence of thrombophilia in stable claudicants is 25% and increases to 40% in those requiring revascularisation, compared to only 11% in the control group. The overall prevalence of thrombophilia defects in patients with premature atherosclerosis appears to be between 15 and 30%. The prevalence in the typical cohort of patients with PVD appears to be similar. All these studies have recruited patients with symptoms significant enough to warrant intervention. The overall prevalence of thrombophilia calculated from these trials, therefore, may not be truly indicative of the general vascular population who may not even present primary or secondary healthcare. The risk of thrombotic occlusion following arterial revascularisation in patients with an identified thrombophilia defect appears to be almost three times that of patients with no evidence of a thrombophilia defect. The best management of these patients has not been determined and needs to be evaluated by prospective randomized trials.

Thrombophilia and Arteriovenous Fistula Survival in ESRD

“…Antiphospholipid antibodies were more common in men but did not seem to affect the AVF outcome. High incidence of thrombophilia is reportedly associated with risk of thrombosis after access surgery or revascularization among patients with ESRD and those with other vascular conditions (2,11,14). The difference in thrombophilia prevalence among the studies reflects various definitions of thrombophilia.…”

Manifestations of Chronic Disease During Pregnancy

“…Although thrombophilia is attributed to the risk of venous thrombosis and pregnancy complications, it may also contribute to development of arterial disease in relation to the progression of atherosclerosis. 99 Hormone replacement therapy with estrogen is known to increase the risk of venous thrombosis (by 2-to 3-fold), which becomes relevant with aging and presence of thrombophilia. 4 Thus, knowledge of thrombophilia, identified during pregnancy, can lead to better preventive measures during at-risk situations such as surgery, long-distance travel, contraception and hormone therapy use, and subsequent pregnancy.…”

Reduced Protein C Activity Might be Associated With Progression of Peripheral Arterial Disease

“…[6][7][8][9] Vig et al 10 reported that a quarter of patients with PAD had evidence of thrombophilia. In their other review article, 11 the risk of thrombotic occlusion following arterial revascularization in patients with an identified thrombophilia defect appeared to be almost 3 times that in patients without it. From the present data, the reduced PC activity was a significant determinant factor of CLI.…”