Do Factor V Leiden and Prothrombin G20210A Mutations Predict Recurrent Venous Thromboembolism in Older Patients? - 17/09/17
, Andreas Limacher, PhD c, Odile Stalder, MSc c, Anne Angelillo-Scherrer, MD d, e, Lorenzo Alberio, MD f, Pierre Fontana, MD, PhD g, Hans-Jürg Beer, MD h, Nicolas Rodondi, MD, MAS a, i, Bernhard Lämmle, MD d, j, Drahomir Aujesky, MD, MSc aAbstract |
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 9 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% had a prothrombin G20210A mutation. 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 with 16.7% (95% CI, 12.5%-22.1%) of patients without mutation (P = .91 by the log-rank test). After adjustment, neither the Factor V Leiden (sub-hazard ratio 0.98; 95% CI, 0.35-2.77) nor the prothrombin G20210A mutation (sub-hazard ratio 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.
Le texte complet de cet article est disponible en PDF.Keywords : Elderly, Recurrent venous thromboembolism, Thrombophilia
Plan
| Funding: The study was supported by a grant from the Swiss National Science Foundation (SNSF) (33CSCO-122659/139470). |
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| Conflict of Interest: The authors have no conflicts of interest. |
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| Authorship: Planning of the study: MM, AL, DA; Obtaining funding: H-JB, AA-S, BL, NR, DA; Data collection: H-JB, AA-S, BL, NR, DA; Statistical analyses: AL, OS; Laboratory measurements and interpretation of results: PF, LA, BL, AA-S; Drafting of the manuscript: MM, AL, DA; Intellectual review of the manuscript: H-JB, AA-S, PF, LA, BL, NR, DA. All authors had access to the data. |
Vol 130 - N° 10
P. 1220.e17-1220.e22 - octobre 2017 Retour au numéro
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