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| [PMID]: | 27986523 |
| [Au] Autor: | Tzoran I; Papadakis M; Brenner B; Fidalgo Á; Rivas A; Wells PS; Gavín O; Adarraga MD; Moustafa F; Monreal M; Registro Informatizado de Enfermedad TromboEmbólica Investigators |
| [Ad] Endereço: | Department of Haematology and Bone Marrow Transplantation, Rambam Health Care Campus, Haifa, Israel. Electronic address: i_tzoran@rambam.health.gov.il. |
| [Ti] Título: | Outcome of Patients with Venous Thromboembolism and Factor V Leiden or Prothrombin 20210 Carrier Mutations During the Course of Anticoagulation. |
| [So] Source: | Am J Med;130(4):482.e1-482.e9, 2017 Apr. | | [Is] ISSN: | 1555-7162 |
| [Cp] País de publicação: | United States |
| [La] Idioma: | eng |
| [Ab] Resumo: | 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. |
| [Mh] Termos MeSH primário: |
Resistência à Proteína C Ativada/complicações
Anticoagulantes/uso terapêutico
Fator V/genética
Protrombina/genética
Tromboembolia Venosa/genética
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| [Mh] Termos MeSH secundário: |
Feminino
Hemorragia/induzido quimicamente
Hemorragia/etiologia
Hemorragia/genética
Heterozigoto
Seres Humanos
Masculino
Meia-Idade
Mutação/genética
Fatores de Risco
Resultado do Tratamento
Tromboembolia Venosa/tratamento farmacológico
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| [Pt] Tipo de publicação: | JOURNAL ARTICLE |
[Nm] Nome de substância:
| 0 (Anticoagulants); 0 (factor V Leiden); 9001-24-5 (Factor V); 9001-26-7 (Prothrombin) |
| [Em] Mês de entrada: | 1705 |
| [Cu] Atualização por classe: | 170510 |
[Lr] Data última revisão:
| 170510 |
| [Sb] Subgrupo de revista: | AIM; IM |
| [Da] Data de entrada para processamento: | 161218 |
| [St] Status: | MEDLINE |
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