Outcome of Patients with Venous Thromboembolism and Factor V Leiden or Prothrombin 20210 Carrier Mutations During the Course of Anticoagulation

Inna Tzoran; Manolis Papadakis; Benjamin Brenner; Ángeles Fidalgo; Agustina Rivas; Philip S. Wells; Olga Gavín; María Dolores Adarraga; Farès Moustafa; Manuel Monreal; Hervé Decousus; Paolo Prandoni; Raquel Barba; Pierpaolo Di Micco; Laurent Bertoletti; Abilio Reis; Marijan Bosevski; Henri Bounameaux; Radovan Malý; Philip Wells; M. A. Aibar; M. Alfonso; J. I. Arcelus; M. Barrón; B. Barrón-Andrés; J. Bascuñana; A. Blanco-Molina; T. Bueso; G. Cañada; I. Cañas; N. Chic; R. del Pozo; J. del Toro; M. C. Díaz-Pedroche; J. A. Díaz-Peromingo; C. Falgá; C. Fernández-Capitán; M. A. Fidalgo; C. Font; L. Font; P. Gallego; A. García; M. A. García; F. García-Bragado; P. García-Brotons; C. Gómez; V. Gómez; J. González; D. González-Marcano; E. Grau; A. Grimón; R. Guijarro; J. Gutiérrez; G. Hernández-Comes; L. Hernández-Blasco; M. J. Hermosa-Los Arcos; L. Jara-Palomares; M. J. Jaras; D. Jiménez; M. D. Joya; P. Llamas; R. Lecumberri; J. L. Lobo; P. López; L. López-Jiménez; R. López-Reyes; J. B. López-Sáez; M. A. Lorente; A. Lorenzo; A. Maestre; P. J. Marchena; F. Martín-Martos; J. A. Nieto; S. Nieto; A. Núñez; M. J. Núñez; M. Odriozola; R. Otero; J. M. Pedrajas; G. Pérez; C. Pérez-Ductor; M. L. Peris; J. A. Porras; O. Reig; A. Riera-Mestre; D. Riesco; C. Rodríguez; M. A. Rodríguez-Dávila; V. Rosa; N. Ruiz-Giménez; J. C. Sahuquillo; M. C. Sala-Sainz; A. Sampériz; R. Sánchez-Martínez; R. Sánchez Simón-Talero; O. Sanz; S. Soler; J. M. Suriñach; M. I. Torres; J. Trujillo-Santos; F. Uresandi; B. Valero; R. Valle; J. Vela; M. P. Vicente; A. Villalobos; T. Vanassche; P. Verhamme; J. Hirmerova; T. Tomko; G. del Pozo; E. Salgado; G. T. Sánchez; A. Bura-Riviere; I. Mahé; A. Merah; A. Braester; G. Antonucci; G. Barillari; F. Bilora; C. Bortoluzzi; C. Cattabiani; M. Ciammaichella; J. Di Biase; R. Duce; P. Ferrazzi; M. Giorgi-Pierfranceschi; E. Grandone; E. Imbalzano; C. Lodigiani; R. Maida; D. Mastroiacovo; F. Pace; R. Pesavento; M. Pinelli; R. Poggio; L. Rota; E. Tiraferri; D. Tonello; A. Tufano; A. Visonà; B. Zalunardo; V. Gibietis; A. Skride; B. Vitola; P. Monteiro; J. L. Ribeiro; M. S. Sousa; M. Zdraveska; L. Calanca; A. Erdmann; L. Mazzolai

doi:10.1016/j.amjmed.2016.11.016

Outcome of Patients with Venous Thromboembolism and Factor V Leiden or Prothrombin 20210 Carrier Mutations During the Course of Anticoagulation

Inna Tzoran, Manolis Papadakis, Benjamin Brenner, Ángeles Fidalgo, Agustina Rivas, Philip S. Wells, Olga Gavín, María Dolores Adarraga, Farès Moustafa, Manuel Monreal, Hervé Decousus, Paolo Prandoni, Raquel Barba, Pierpaolo Di Micco, Laurent Bertoletti, Abilio Reis, Marijan Bosevski, Henri Bounameaux, Radovan Malý, Philip WellsM. A. Aibar, M. Alfonso, J. I. Arcelus, M. Barrón, B. Barrón-Andrés, J. Bascuñana, A. Blanco-Molina, T. Bueso, G. Cañada, I. Cañas, N. Chic, R. del Pozo, J. del Toro, M. C. Díaz-Pedroche, J. A. Díaz-Peromingo, C. Falgá, C. Fernández-Capitán, M. A. Fidalgo, C. Font, L. Font, P. Gallego, A. García, M. A. García, F. García-Bragado, P. García-Brotons, C. Gómez, V. Gómez, J. González, D. González-Marcano, E. Grau, A. Grimón, R. Guijarro, J. Gutiérrez, G. Hernández-Comes, L. Hernández-Blasco, M. J. Hermosa-Los Arcos, L. Jara-Palomares, M. J. Jaras, D. Jiménez, M. D. Joya, P. Llamas, R. Lecumberri, J. L. Lobo, P. López, L. López-Jiménez, R. López-Reyes, J. B. López-Sáez, M. A. Lorente, A. Lorenzo, A. Maestre, P. J. Marchena, F. Martín-Martos, J. A. Nieto, S. Nieto, A. Núñez, M. J. Núñez, M. Odriozola, R. Otero, J. M. Pedrajas, G. Pérez, C. Pérez-Ductor, M. L. Peris, J. A. Porras, O. Reig, A. Riera-Mestre, D. Riesco, C. Rodríguez, M. A. Rodríguez-Dávila, V. Rosa, N. Ruiz-Giménez, J. C. Sahuquillo, M. C. Sala-Sainz, A. Sampériz, R. Sánchez-Martínez, R. Sánchez Simón-Talero, O. Sanz, S. Soler, J. M. Suriñach, M. I. Torres, J. Trujillo-Santos, F. Uresandi, B. Valero, R. Valle, J. Vela, M. P. Vicente, A. Villalobos, T. Vanassche, P. Verhamme, J. Hirmerova, T. Tomko, G. del Pozo, E. Salgado, G. T. Sánchez, A. Bura-Riviere, I. Mahé, A. Merah, A. Braester, G. Antonucci, G. Barillari, F. Bilora, C. Bortoluzzi, C. Cattabiani, M. Ciammaichella, J. Di Biase, R. Duce, P. Ferrazzi, M. Giorgi-Pierfranceschi, E. Grandone, E. Imbalzano, C. Lodigiani, R. Maida, D. Mastroiacovo, F. Pace, R. Pesavento, M. Pinelli, R. Poggio, L. Rota, E. Tiraferri, D. Tonello, A. Tufano, A. Visonà, B. Zalunardo, V. Gibietis, A. Skride, B. Vitola, P. Monteiro, J. L. Ribeiro, M. S. Sousa, M. Zdraveska, L. Calanca, A. Erdmann, L. Mazzolai

Bar-Ilan University - Azrieli Faculty of Medicine

Research output: Contribution to journal › Article › peer-review

10 Scopus citations

Abstract

Background Individuals with factor V Leiden or prothrombin G20210A mutations are at a higher risk to develop venous thromboembolism. However, the influence of these polymorphisms on patient outcome during anticoagulant therapy has not been consistently explored. Methods We used the Registro Informatizado de Enfermedad TromboEmbólica database to compare rates of venous thromboembolism recurrence and bleeding events occurring during the anticoagulation course in factor V Leiden carriers, prothrombin mutation carriers, and noncarriers. Results Between March 2001 and December 2015, 10,139 patients underwent thrombophilia testing. Of these, 1384 were factor V Leiden carriers, 1115 were prothrombin mutation carriers, and 7640 were noncarriers. During the anticoagulation course, 160 patients developed recurrent deep vein thrombosis and 94 patients developed pulmonary embolism (16 died); 154 patients had major bleeding (10 died), and 291 patients had nonmajor bleeding. On multivariable analysis, factor V Leiden carriers had a similar rate of venous thromboembolism recurrence (adjusted hazard ratio [HR], 1.16; 95% confidence interval [CI], 0.82-1.64), half the rate of major bleeding (adjusted HR, 0.50; 95% CI, 0.25-0.99) and a nonsignificantly lower rate of nonmajor bleeding (adjusted HR, 0.66; 95% CI, 0.43-1.01) than noncarriers. Prothrombin mutation carriers and noncarriers had a comparable rate of venous thromboembolism recurrence (adjusted HR, 1.00; 95% CI, 0.68-1.48), major bleeding (adjusted HR, 0.75; 95% CI, 0.42-1.34), and nonmajor bleeding events (adjusted HR, 1.10; 95% CI, 0.77-1.57). Conclusions During the anticoagulation course, factor V Leiden carriers had a similar risk for venous thromboembolism recurrence and half the risk for major bleeding compared with noncarriers. This finding may contribute to decision-making regarding anticoagulation duration in selected factor V Leiden carriers with venous thromboembolism.

Original language	English
Pages (from-to)	482.e1-482.e9
Journal	American Journal of Medicine
Volume	130
Issue number	4
DOIs	https://doi.org/10.1016/j.amjmed.2016.11.016
State	Published - 1 Apr 2017

Bibliographical note

Publisher Copyright:
© 2017

Keywords

Anticoagulant therapy
Bleeding
Thrombophilia
Venous thromboembolism

Access to Document

10.1016/j.amjmed.2016.11.016

Cite this

Tzoran, I., Papadakis, M., Brenner, B., Fidalgo, Á., Rivas, A., Wells, P. S., Gavín, O., Adarraga, M. D., Moustafa, F., Monreal, M., Decousus, H., Prandoni, P., Barba, R., Di Micco, P., Bertoletti, L., Reis, A., Bosevski, M., Bounameaux, H., Malý, R., ... Mazzolai, L. (2017). Outcome of Patients with Venous Thromboembolism and Factor V Leiden or Prothrombin 20210 Carrier Mutations During the Course of Anticoagulation. American Journal of Medicine, 130(4), 482.e1-482.e9. https://doi.org/10.1016/j.amjmed.2016.11.016

@article{0e1d46fa734341ff87137d90b83d0fab,

title = "Outcome of Patients with Venous Thromboembolism and Factor V Leiden or Prothrombin 20210 Carrier Mutations During the Course of Anticoagulation",

abstract = "Background Individuals with factor V Leiden or prothrombin G20210A mutations are at a higher risk to develop venous thromboembolism. However, the influence of these polymorphisms on patient outcome during anticoagulant therapy has not been consistently explored. Methods We used the Registro Informatizado de Enfermedad TromboEmb{\'o}lica database to compare rates of venous thromboembolism recurrence and bleeding events occurring during the anticoagulation course in factor V Leiden carriers, prothrombin mutation carriers, and noncarriers. Results Between March 2001 and December 2015, 10,139 patients underwent thrombophilia testing. Of these, 1384 were factor V Leiden carriers, 1115 were prothrombin mutation carriers, and 7640 were noncarriers. During the anticoagulation course, 160 patients developed recurrent deep vein thrombosis and 94 patients developed pulmonary embolism (16 died); 154 patients had major bleeding (10 died), and 291 patients had nonmajor bleeding. On multivariable analysis, factor V Leiden carriers had a similar rate of venous thromboembolism recurrence (adjusted hazard ratio [HR], 1.16; 95% confidence interval [CI], 0.82-1.64), half the rate of major bleeding (adjusted HR, 0.50; 95% CI, 0.25-0.99) and a nonsignificantly lower rate of nonmajor bleeding (adjusted HR, 0.66; 95% CI, 0.43-1.01) than noncarriers. Prothrombin mutation carriers and noncarriers had a comparable rate of venous thromboembolism recurrence (adjusted HR, 1.00; 95% CI, 0.68-1.48), major bleeding (adjusted HR, 0.75; 95% CI, 0.42-1.34), and nonmajor bleeding events (adjusted HR, 1.10; 95% CI, 0.77-1.57). Conclusions During the anticoagulation course, factor V Leiden carriers had a similar risk for venous thromboembolism recurrence and half the risk for major bleeding compared with noncarriers. This finding may contribute to decision-making regarding anticoagulation duration in selected factor V Leiden carriers with venous thromboembolism.",

keywords = "Anticoagulant therapy, Bleeding, Thrombophilia, Venous thromboembolism",

author = "Inna Tzoran and Manolis Papadakis and Benjamin Brenner and {\'A}ngeles Fidalgo and Agustina Rivas and Wells, {Philip S.} and Olga Gav{\'i}n and Adarraga, {Mar{\'i}a Dolores} and Far{\`e}s Moustafa and Manuel Monreal and Herv{\'e} Decousus and Paolo Prandoni and Raquel Barba and {Di Micco}, Pierpaolo and Laurent Bertoletti and Abilio Reis and Marijan Bosevski and Henri Bounameaux and Radovan Mal{\'y} and Philip Wells and Aibar, {M. A.} and M. Alfonso and Arcelus, {J. I.} and M. Barr{\'o}n and B. Barr{\'o}n-Andr{\'e}s and J. Bascu{\~n}ana and A. Blanco-Molina and T. Bueso and G. Ca{\~n}ada and I. Ca{\~n}as and N. Chic and {del Pozo}, R. and {del Toro}, J. and D{\'i}az-Pedroche, {M. C.} and D{\'i}az-Peromingo, {J. A.} and C. Falg{\'a} and C. Fern{\'a}ndez-Capit{\'a}n and Fidalgo, {M. A.} and C. Font and L. Font and P. Gallego and A. Garc{\'i}a and Garc{\'i}a, {M. A.} and F. Garc{\'i}a-Bragado and P. Garc{\'i}a-Brotons and C. G{\'o}mez and V. G{\'o}mez and J. Gonz{\'a}lez and D. Gonz{\'a}lez-Marcano and E. Grau and A. Grim{\'o}n and R. Guijarro and J. Guti{\'e}rrez and G. Hern{\'a}ndez-Comes and L. Hern{\'a}ndez-Blasco and {Hermosa-Los Arcos}, {M. J.} and L. Jara-Palomares and Jaras, {M. J.} and D. Jim{\'e}nez and Joya, {M. D.} and P. Llamas and R. Lecumberri and Lobo, {J. L.} and P. L{\'o}pez and L. L{\'o}pez-Jim{\'e}nez and R. L{\'o}pez-Reyes and L{\'o}pez-S{\'a}ez, {J. B.} and Lorente, {M. A.} and A. Lorenzo and A. Maestre and Marchena, {P. J.} and F. Mart{\'i}n-Martos and Nieto, {J. A.} and S. Nieto and A. N{\'u}{\~n}ez and N{\'u}{\~n}ez, {M. J.} and M. Odriozola and R. Otero and Pedrajas, {J. M.} and G. P{\'e}rez and C. P{\'e}rez-Ductor and Peris, {M. L.} and Porras, {J. A.} and O. Reig and A. Riera-Mestre and D. Riesco and C. Rodr{\'i}guez and Rodr{\'i}guez-D{\'a}vila, {M. A.} and V. Rosa and N. Ruiz-Gim{\'e}nez and Sahuquillo, {J. C.} and Sala-Sainz, {M. C.} and A. Samp{\'e}riz and R. S{\'a}nchez-Mart{\'i}nez and {S{\'a}nchez Sim{\'o}n-Talero}, R. and O. Sanz and S. Soler and Suri{\~n}ach, {J. M.} and Torres, {M. I.} and J. Trujillo-Santos and F. Uresandi and B. Valero and R. Valle and J. Vela and Vicente, {M. P.} and A. Villalobos and T. Vanassche and P. Verhamme and J. Hirmerova and T. Tomko and {del Pozo}, G. and E. Salgado and S{\'a}nchez, {G. T.} and A. Bura-Riviere and I. Mah{\'e} and A. Merah and A. Braester and G. Antonucci and G. Barillari and F. Bilora and C. Bortoluzzi and C. Cattabiani and M. Ciammaichella and {Di Biase}, J. and R. Duce and P. Ferrazzi and M. Giorgi-Pierfranceschi and E. Grandone and E. Imbalzano and C. Lodigiani and R. Maida and D. Mastroiacovo and F. Pace and R. Pesavento and M. Pinelli and R. Poggio and L. Rota and E. Tiraferri and D. Tonello and A. Tufano and A. Vison{\`a} and B. Zalunardo and V. Gibietis and A. Skride and B. Vitola and P. Monteiro and Ribeiro, {J. L.} and Sousa, {M. S.} and M. Zdraveska and L. Calanca and A. Erdmann and L. Mazzolai",

note = "Publisher Copyright: {\textcopyright} 2017",

year = "2017",

month = apr,

day = "1",

doi = "10.1016/j.amjmed.2016.11.016",

language = "אנגלית",

volume = "130",

pages = "482.e1--482.e9",

journal = "American Journal of Medicine",

issn = "0002-9343",

publisher = "Elsevier Inc.",

number = "4",

}

Tzoran, I, Papadakis, M, Brenner, B, Fidalgo, Á, Rivas, A, Wells, PS, Gavín, O, Adarraga, MD, Moustafa, F, Monreal, M, Decousus, H, Prandoni, P, Barba, R, Di Micco, P, Bertoletti, L, Reis, A, Bosevski, M, Bounameaux, H, Malý, R, Wells, P, Aibar, MA, Alfonso, M, Arcelus, JI, Barrón, M, Barrón-Andrés, B, Bascuñana, J, Blanco-Molina, A, Bueso, T, Cañada, G, Cañas, I, Chic, N, del Pozo, R, del Toro, J, Díaz-Pedroche, MC, Díaz-Peromingo, JA, Falgá, C, Fernández-Capitán, C, Fidalgo, MA, Font, C, Font, L, Gallego, P, García, A, García, MA, García-Bragado, F, García-Brotons, P, Gómez, C, Gómez, V, González, J, González-Marcano, D, Grau, E, Grimón, A, Guijarro, R, Gutiérrez, J, Hernández-Comes, G, Hernández-Blasco, L, Hermosa-Los Arcos, MJ, Jara-Palomares, L, Jaras, MJ, Jiménez, D, Joya, MD, Llamas, P, Lecumberri, R, Lobo, JL, López, P, López-Jiménez, L, López-Reyes, R, López-Sáez, JB, Lorente, MA, Lorenzo, A, Maestre, A, Marchena, PJ, Martín-Martos, F, Nieto, JA, Nieto, S, Núñez, A, Núñez, MJ, Odriozola, M, Otero, R, Pedrajas, JM, Pérez, G, Pérez-Ductor, C, Peris, ML, Porras, JA, Reig, O, Riera-Mestre, A, Riesco, D, Rodríguez, C, Rodríguez-Dávila, MA, Rosa, V, Ruiz-Giménez, N, Sahuquillo, JC, Sala-Sainz, MC, Sampériz, A, Sánchez-Martínez, R, Sánchez Simón-Talero, R, Sanz, O, Soler, S, Suriñach, JM, Torres, MI, Trujillo-Santos, J, Uresandi, F, Valero, B, Valle, R, Vela, J, Vicente, MP, Villalobos, A, Vanassche, T, Verhamme, P, Hirmerova, J, Tomko, T, del Pozo, G, Salgado, E, Sánchez, GT, Bura-Riviere, A, Mahé, I, Merah, A, Braester, A, Antonucci, G, Barillari, G, Bilora, F, Bortoluzzi, C, Cattabiani, C, Ciammaichella, M, Di Biase, J, Duce, R, Ferrazzi, P, Giorgi-Pierfranceschi, M, Grandone, E, Imbalzano, E, Lodigiani, C, Maida, R, Mastroiacovo, D, Pace, F, Pesavento, R, Pinelli, M, Poggio, R, Rota, L, Tiraferri, E, Tonello, D, Tufano, A, Visonà, A, Zalunardo, B, Gibietis, V, Skride, A, Vitola, B, Monteiro, P, Ribeiro, JL, Sousa, MS, Zdraveska, M, Calanca, L, Erdmann, A & Mazzolai, L 2017, 'Outcome of Patients with Venous Thromboembolism and Factor V Leiden or Prothrombin 20210 Carrier Mutations During the Course of Anticoagulation', American Journal of Medicine, vol. 130, no. 4, pp. 482.e1-482.e9. https://doi.org/10.1016/j.amjmed.2016.11.016

TY - JOUR

T1 - Outcome of Patients with Venous Thromboembolism and Factor V Leiden or Prothrombin 20210 Carrier Mutations During the Course of Anticoagulation

AU - Tzoran, Inna

AU - Papadakis, Manolis

AU - Brenner, Benjamin

AU - Fidalgo, Ángeles

AU - Rivas, Agustina

AU - Wells, Philip S.

AU - Gavín, Olga

AU - Adarraga, María Dolores

AU - Moustafa, Farès

AU - Monreal, Manuel

AU - Decousus, Hervé

AU - Prandoni, Paolo

AU - Barba, Raquel

AU - Di Micco, Pierpaolo

AU - Bertoletti, Laurent

AU - Reis, Abilio

AU - Bosevski, Marijan

AU - Bounameaux, Henri

AU - Malý, Radovan

AU - Wells, Philip

AU - Aibar, M. A.

AU - Alfonso, M.

AU - Arcelus, J. I.

AU - Barrón, M.

AU - Barrón-Andrés, B.

AU - Bascuñana, J.

AU - Blanco-Molina, A.

AU - Bueso, T.

AU - Cañada, G.

AU - Cañas, I.

AU - Chic, N.

AU - del Pozo, R.

AU - del Toro, J.

AU - Díaz-Pedroche, M. C.

AU - Díaz-Peromingo, J. A.

AU - Falgá, C.

AU - Fernández-Capitán, C.

AU - Fidalgo, M. A.

AU - Font, C.

AU - Font, L.

AU - Gallego, P.

AU - García, A.

AU - García, M. A.

AU - García-Bragado, F.

AU - García-Brotons, P.

AU - Gómez, C.

AU - Gómez, V.

AU - González, J.

AU - González-Marcano, D.

AU - Grau, E.

AU - Grimón, A.

AU - Guijarro, R.

AU - Gutiérrez, J.

AU - Hernández-Comes, G.

AU - Hernández-Blasco, L.

AU - Hermosa-Los Arcos, M. J.

AU - Jara-Palomares, L.

AU - Jaras, M. J.

AU - Jiménez, D.

AU - Joya, M. D.

AU - Llamas, P.

AU - Lecumberri, R.

AU - Lobo, J. L.

AU - López, P.

AU - López-Jiménez, L.

AU - López-Reyes, R.

AU - López-Sáez, J. B.

AU - Lorente, M. A.

AU - Lorenzo, A.

AU - Maestre, A.

AU - Marchena, P. J.

AU - Martín-Martos, F.

AU - Nieto, J. A.

AU - Nieto, S.

AU - Núñez, A.

AU - Núñez, M. J.

AU - Odriozola, M.

AU - Otero, R.

AU - Pedrajas, J. M.

AU - Pérez, G.

AU - Pérez-Ductor, C.

AU - Peris, M. L.

AU - Porras, J. A.

AU - Reig, O.

AU - Riera-Mestre, A.

AU - Riesco, D.

AU - Rodríguez, C.

AU - Rodríguez-Dávila, M. A.

AU - Rosa, V.

AU - Ruiz-Giménez, N.

AU - Sahuquillo, J. C.

AU - Sala-Sainz, M. C.

AU - Sampériz, A.

AU - Sánchez-Martínez, R.

AU - Sánchez Simón-Talero, R.

AU - Sanz, O.

AU - Soler, S.

AU - Suriñach, J. M.

AU - Torres, M. I.

AU - Trujillo-Santos, J.

AU - Uresandi, F.

AU - Valero, B.

AU - Valle, R.

AU - Vela, J.

AU - Vicente, M. P.

AU - Villalobos, A.

AU - Vanassche, T.

AU - Verhamme, P.

AU - Hirmerova, J.

AU - Tomko, T.

AU - del Pozo, G.

AU - Salgado, E.

AU - Sánchez, G. T.

AU - Bura-Riviere, A.

AU - Mahé, I.

AU - Merah, A.

AU - Braester, A.

AU - Antonucci, G.

AU - Barillari, G.

AU - Bilora, F.

AU - Bortoluzzi, C.

AU - Cattabiani, C.

AU - Ciammaichella, M.

AU - Di Biase, J.

AU - Duce, R.

AU - Ferrazzi, P.

AU - Giorgi-Pierfranceschi, M.

AU - Grandone, E.

AU - Imbalzano, E.

AU - Lodigiani, C.

AU - Maida, R.

AU - Mastroiacovo, D.

AU - Pace, F.

AU - Pesavento, R.

AU - Pinelli, M.

AU - Poggio, R.

AU - Rota, L.

AU - Tiraferri, E.

AU - Tonello, D.

AU - Tufano, A.

AU - Visonà, A.

AU - Zalunardo, B.

AU - Gibietis, V.

AU - Skride, A.

AU - Vitola, B.

AU - Monteiro, P.

AU - Ribeiro, J. L.

AU - Sousa, M. S.

AU - Zdraveska, M.

AU - Calanca, L.

AU - Erdmann, A.

AU - Mazzolai, L.

PY - 2017/4/1

Y1 - 2017/4/1

N2 - Background Individuals with factor V Leiden or prothrombin G20210A mutations are at a higher risk to develop venous thromboembolism. However, the influence of these polymorphisms on patient outcome during anticoagulant therapy has not been consistently explored. Methods We used the Registro Informatizado de Enfermedad TromboEmbólica database to compare rates of venous thromboembolism recurrence and bleeding events occurring during the anticoagulation course in factor V Leiden carriers, prothrombin mutation carriers, and noncarriers. Results Between March 2001 and December 2015, 10,139 patients underwent thrombophilia testing. Of these, 1384 were factor V Leiden carriers, 1115 were prothrombin mutation carriers, and 7640 were noncarriers. During the anticoagulation course, 160 patients developed recurrent deep vein thrombosis and 94 patients developed pulmonary embolism (16 died); 154 patients had major bleeding (10 died), and 291 patients had nonmajor bleeding. On multivariable analysis, factor V Leiden carriers had a similar rate of venous thromboembolism recurrence (adjusted hazard ratio [HR], 1.16; 95% confidence interval [CI], 0.82-1.64), half the rate of major bleeding (adjusted HR, 0.50; 95% CI, 0.25-0.99) and a nonsignificantly lower rate of nonmajor bleeding (adjusted HR, 0.66; 95% CI, 0.43-1.01) than noncarriers. Prothrombin mutation carriers and noncarriers had a comparable rate of venous thromboembolism recurrence (adjusted HR, 1.00; 95% CI, 0.68-1.48), major bleeding (adjusted HR, 0.75; 95% CI, 0.42-1.34), and nonmajor bleeding events (adjusted HR, 1.10; 95% CI, 0.77-1.57). Conclusions During the anticoagulation course, factor V Leiden carriers had a similar risk for venous thromboembolism recurrence and half the risk for major bleeding compared with noncarriers. This finding may contribute to decision-making regarding anticoagulation duration in selected factor V Leiden carriers with venous thromboembolism.

AB - Background Individuals with factor V Leiden or prothrombin G20210A mutations are at a higher risk to develop venous thromboembolism. However, the influence of these polymorphisms on patient outcome during anticoagulant therapy has not been consistently explored. Methods We used the Registro Informatizado de Enfermedad TromboEmbólica database to compare rates of venous thromboembolism recurrence and bleeding events occurring during the anticoagulation course in factor V Leiden carriers, prothrombin mutation carriers, and noncarriers. Results Between March 2001 and December 2015, 10,139 patients underwent thrombophilia testing. Of these, 1384 were factor V Leiden carriers, 1115 were prothrombin mutation carriers, and 7640 were noncarriers. During the anticoagulation course, 160 patients developed recurrent deep vein thrombosis and 94 patients developed pulmonary embolism (16 died); 154 patients had major bleeding (10 died), and 291 patients had nonmajor bleeding. On multivariable analysis, factor V Leiden carriers had a similar rate of venous thromboembolism recurrence (adjusted hazard ratio [HR], 1.16; 95% confidence interval [CI], 0.82-1.64), half the rate of major bleeding (adjusted HR, 0.50; 95% CI, 0.25-0.99) and a nonsignificantly lower rate of nonmajor bleeding (adjusted HR, 0.66; 95% CI, 0.43-1.01) than noncarriers. Prothrombin mutation carriers and noncarriers had a comparable rate of venous thromboembolism recurrence (adjusted HR, 1.00; 95% CI, 0.68-1.48), major bleeding (adjusted HR, 0.75; 95% CI, 0.42-1.34), and nonmajor bleeding events (adjusted HR, 1.10; 95% CI, 0.77-1.57). Conclusions During the anticoagulation course, factor V Leiden carriers had a similar risk for venous thromboembolism recurrence and half the risk for major bleeding compared with noncarriers. This finding may contribute to decision-making regarding anticoagulation duration in selected factor V Leiden carriers with venous thromboembolism.

KW - Anticoagulant therapy

KW - Bleeding

KW - Thrombophilia

KW - Venous thromboembolism

UR - http://www.scopus.com/inward/record.url?scp=85009811966&partnerID=8YFLogxK

U2 - 10.1016/j.amjmed.2016.11.016

DO - 10.1016/j.amjmed.2016.11.016

M3 - ???researchoutput.researchoutputtypes.contributiontojournal.article???

C2 - 27986523

AN - SCOPUS:85009811966

SN - 0002-9343

VL - 130

SP - 482.e1-482.e9

JO - American Journal of Medicine

JF - American Journal of Medicine

IS - 4

ER -

Outcome of Patients with Venous Thromboembolism and Factor V Leiden or Prothrombin 20210 Carrier Mutations During the Course of Anticoagulation

Abstract

Bibliographical note

Keywords

Access to Document

Other files and links

Fingerprint

Cite this