Influence of factor VIII/von Willebrand complex on the activated protein C-resistance phenotype and on the risk for venous thromboembolism in heterozygous carriers of the factor V Leiden mutation.
Blood Coagul Fibrinolysis
; 10(7): 409-16, 1999 Oct.
Article
em En
| MEDLINE
| ID: mdl-10695766
ABSTRACT
High factor VIII plasma levels have been shown to represent a common increased risk for venous thromboembolism (VTE) and may cause an activated protein C (APC) resistance in the absence of the factor V Leiden mutation, but there are no studies specifically aimed to establish if high factor VIII and von Willebrand factor (vWF) concentrations may influence the APC sensitivity ratio (APC-SR) and increase the risk for VTE in the presence of the factor V Leiden mutation. For this purpose, we performed a retrospective case-control study to investigate the influence of the procoagulant factor VIII (VIIIC) and the antigen of vWF (vWFAg) on the normalized APC-SR (n-APC-SR) and on the risk for VTE, in two selected groups of 30 symptomatic (Group I) and 32 asymptomatic (Group II) related heterozygotes for the factor V Leiden mutation. Differences between the two groups (Group I versus Group II) were n-APC-SR, 0.57+/-0.06 versus 0.63+/-0.08, P = 0.001; factor VIIIC, 1.49+/-0.42 versus 1.13+/-0.28 IU/ml, P<0.001; vWFAg, 1.46+/-0.53 versus 1.26+/-0.32 IU/ml, NS. As a whole (Group I + Group II), Pearson correlation coefficients were n-APC-SR versus factor VIIIC, r = -0.410, P = 0.001; n-APC-SR versus vWFAg, r = -0.309, P = 0.01; factor VIIIC versus vWFAg, r = +0.640, P<0.0001. The relative risk for VTE in individuals with the factor VIIIC concentration > 1.5 IU/ml was 2.5 (95% confidence interval 1.6-3.9). We concluded that high factor VIIIC levels, probably in the effect of vWF, play a determinant role in worsening the APC-resistance phenotype and represent a common additional risk factor for VTE in heterozygous carriers of the factor V Leiden mutation.
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Base de dados:
MEDLINE
Assunto principal:
Fator V
/
Fator VIII
/
Fator de von Willebrand
/
Proteína C
/
Trombose Venosa
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Blood Coagul Fibrinolysis
Assunto da revista:
ANGIOLOGIA
/
HEMATOLOGIA
Ano de publicação:
1999
Tipo de documento:
Article
País de afiliação:
Itália