Selective screening for the Factor V Leiden mutation: is it advisable prior to the prescription of oral contraceptives?
Thromb Haemost
; 78(6): 1480-3, 1997 Dec.
Article
en En
| MEDLINE
| ID: mdl-9423798
ABSTRACT
PIP: The cumulative thrombotic risk of Factor V Leiden (FVL) and oral contraceptive (OC) use raises the possibility of either selective or universal screening for this mutation before OCs are prescribed. Family history of venous thromboembolism as a criterion to detect FVL carriers was evaluated in a case-control study of 101 women from Bavaria, Germany, who had their first and single thromboembolic event while using OCs and 101 healthy age-matched OC users. A questionnaire was administered to a broader group of 609 OC users without a history of thromboembolism. Analysis of the 609 women revealed a 7.4% prevalence of FVL, but no association between this mutation and a family history of thromboembolism. Among women with a previous thromboembolism, a family history in a first-degree relative had a positive predictive value of only 14% for FVL. The sensitivity of family history was under 50%. 35% of cases compared with 8% of controls carried the FVL mutation. The most significant independent risk factors of thromboembolism were inherited FVL (odds ratio, 4.9) and acquired risk factors--i.e., surgery, leg fractures, distortions, confinement to bed for more than 1 week, or a restricted sitting position more than 6 hours in the 4 weeks before the index date (odds ratio, 10.1). Both heterozygote and homozygote FVL carriers did not suffer earlier from thromboembolism than patients without the mutation. These findings indicate that family history is not an effective predictor of FVL. However, even if the advantages of OC use are greater than the thrombotic risk, screening for FVL may be indicated to permit high-risk women to take preventive action.
Palabras clave
Biology; Blood Coagulation Effects; Case Control Studies; Contraception; Contraceptive Methods; Developed Countries; Diseases; Embolism; Europe; Examinations And Diagnoses; Family Planning; Genetics; Germany; Hematological Effects; Hemic System; Oral Contraceptives; Physiology; Research Methodology; Research Report; Risk Factors; Screening; Studies; Thromboembolism; Vascular Diseases; Western Europe
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Factor V
/
Tamizaje Masivo
Tipo de estudio:
Diagnostic_studies
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Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
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Screening_studies
Límite:
Adolescent
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Adult
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Female
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Humans
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Middle aged
Idioma:
En
Revista:
Thromb Haemost
Año:
1997
Tipo del documento:
Article
País de afiliación:
Alemania
Pais de publicación:
Alemania