Do factor V Leiden and prothrombin G20210A mutations predict recurrent venous thromboembolism in older patients?

Méan, Marie; Limacher, Andreas; Stalder, Odile; Angelillo, Anne; Alberio, Lorenzo; Fontana, Pierre; Beer, Hans-Jürg; Rodondi, Nicolas; Laemmle, Bernhard; Aujesky, Drahomir (2017). Do factor V Leiden and prothrombin G20210A mutations predict recurrent venous thromboembolism in older patients? American journal of medicine, 130(10), 1220.e17-1220.e22. Elsevier 10.1016/j.amjmed.2017.05.026

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BACKGROUND The value of genetic thrombophilia testing in elderly patients with an unprovoked venous thromboembolism is unclear. We assessed whether the factor V Leiden and the prothrombin G20210A mutation are associated with recurrent venous thromboembolism in elderly patients in a prospective multicenter cohort study. METHODS We genotyped the factor V Leiden and the prothrombin G20210A mutation in 354 consecutive in- and outpatients aged ≥65 years with a first unprovoked venous thromboembolism from nine Swiss hospitals. Patients and managing physicians were blinded to testing results. The outcome was recurrent symptomatic venous thromboembolism during follow-up. We examined the association between the factor V Leiden and the prothrombin G20210A mutation and venous thromboembolism recurrence using competing risk regression, adjusting for age, sex, and periods of anticoagulation as a time-varying covariate. RESULTS Overall, 9.0% of patients had a factor V Leiden and 3.7% a prothrombin G20210A mutation. The At 36 months of follow-up, patients with a factor V Leiden and a prothrombin G20210A mutation had a cumulative incidence of recurrent venous thromboembolism of 12.9% (95% confidence interval [CI] 5.1-30.8%) and 18.5% (95% CI 4.9-56.5%), respectively, compared to 16.7% (95% CI 12.5-22.1%) of patients without mutation (P=0.91 by the log-rank test). After adjustment, neither the FV Leiden (sub-hazard ratio [SHR] 0.98; 95% CI 0.35-2.77) nor the prothrombin G20210A mutation (SRH 1.15; 95% CI 0.25-5.19) was associated with recurrent venous thromboembolism. CONCLUSION Our results suggest that testing for genetic thrombophilia may not be beneficial in elderly patients with a first unprovoked venous thromboembolism.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Haematology and Central Haematological Laboratory
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > Unit Childrens Hospital > Forschungsgruppe Hämatologie (Erwachsene)
04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine
04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine > Centre of Competence for General Internal Medicine
04 Faculty of Medicine > Medical Education > Institute of General Practice and Primary Care (BIHAM)
04 Faculty of Medicine > Pre-clinic Human Medicine > CTU Bern
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine

UniBE Contributor:

Méan Pascual, Marie; Limacher, Andreas; Stalder, Odile; Angelillo, Anne; Rodondi, Nicolas and Aujesky, Drahomir

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

0002-9343

Publisher:

Elsevier

Language:

English

Submitter:

Doris Kopp Heim

Date Deposited:

06 Jul 2017 12:23

Last Modified:

10 Jun 2018 02:30

Publisher DOI:

10.1016/j.amjmed.2017.05.026

PubMed ID:

28606797

Uncontrolled Keywords:

Elderly; recurrent venous thromboembolism; thrombo philia / Angelillo-Scherrer Anne

BORIS DOI:

10.7892/boris.101809

URI:

https://boris.unibe.ch/id/eprint/101809

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