Prevalence of thrombophilia according to age at the first manifestation of venous thromboembolism: results from the MAISTHRO registry

Abstract

SummaryThrombophilia is a well-established risk factor for a venous thromboembolic event (VTE), and it has been proposed that hereditary thrombophilia may substantially contribute to the development of VTE in young patients. We aimed to analyse the prevalence of thrombophilia with special regard to the age of VTE manifestation. The study cohort consisted of 1490 patients (58% females) with a median age 43 years at the time of their first VTE. At least one thrombophilic disorder was identified in 50Á1% of patients. The probability of detecting a hereditary thrombophilia declined significantly with advancing age (from 49Á3% in patients aged 20 years and younger to 21Á9% in patients over the age of 70 years; P < 0Á001). This may be primarily attributed to the decreasing frequencies of the F5 R506Q (factor V Leiden) mutation and deficiencies of protein C or protein S with older age at the time of the initial VTE event. Moreover, thrombophilia was more prevalent in unprovoked compared with risk-associated VTE (57Á7% vs. 47Á7%; P = 0Á001). The decline in the prevalence of hereditary thrombophilia with older ages supports the use of a selected thrombophilia screening strategy dependent on age and the presence or absence of additional VTE risk factors.

Blood viscosity during coagulation at different shear rates

“…), elderly patients (Weingarz et al. ), and other conditions. Factors associated with a prolonged clotting time are congenital coagulation disorders, like hemophilia, acquired consumption of coagulation factors, like in trauma‐induced coagulopathy and cardiac surgery with cardiopulmonary bypass, and the use of specific drugs, like warfarin, direct thrombin inhibitors, heparin.…”

Pathogenesis, Diagnosis, and Treatment of Venous Thromboembolism in Older Adults

“…Frailty has also recently been found to a risk factor for VTE in older adults . Other less common—but often present—VTE risk factors in older adults include nephrotic syndrome, myeloproliferative disorders, antiphospholipid antibody syndrome, and heparin‐induced thrombocytopenia . Inherited thrombophilia, although commonly identified in younger adults after an index VTE, is a risk factor for thrombosis in older adults as well.…”

“…Inherited thrombophilia, although commonly identified in younger adults after an index VTE, is a risk factor for thrombosis in older adults as well. For example, the factor V Leiden (FVL) mutation, which is the most‐common inherited thrombophilia, causes factor V to be insensitive to degradation by activated protein C. In the general population, up to 20% of individuals presenting with a first episode of VTE are carriers of the FVL mutation, and this is often found in older adults with VTE . Antiphospholipid antibody syndrome is defined when individuals meet two guideline‐recommended criteria: persistent (defined as two positive results ≥12 weeks apart) laboratory evidence of circulating antiphospholipid antibodies (aPL) and a clinical history of thrombosis (or pregnancy‐related morbidity).…”

The role of FV 1691G>A, FII 20210G>A mutations and MTHFR 677C>T; 1298A>C and 103G>T FXIII gene polymorphisms in pathogenesis of intraventricular hemorrhage in infants born before 32 weeks of gestation

“…In fact, in over 90% of patients, it is caused by a point mutation of the factor V (FV) gene at position 1691 ( 1691G>A ). The other types include a mutation in factor II (FII) at position 20210 in the 3′ untranslated region of the gene ( 20210G>A ) and a polymorphism in methylenetetrahydrofolate reductase (MTHFR) gene at position 677 ( 677C>T ) and at 1298 ( 1298A>C ) [1–3]. …”