Prothrombin Fragment F1+2 Is not Predictive for Recurrent Venous Thromboembolism

P A Kyrle; S Eichinger; I Pabinger; A Stümpflen; M Hirschl; C Bialonczyk; B Schneider; C Mannhalter; M Melichart; G Traxler; A Weltermann; W Speiser; K Lechner

doi:10.1055/s-0038-1656062

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 1997; 77(05): 0829-0833
DOI: 10.1055/s-0038-1656062

Cinical Studies

Schattauer GmbH Stuttgart

Prothrombin Fragment F1+2 Is not Predictive for Recurrent Venous Thromboembolism

P A Kyrle

¹The Department of Internal Medicine I, University of Vienna, Austria

,

S Eichinger

¹The Department of Internal Medicine I, University of Vienna, Austria

,

I Pabinger

¹The Department of Internal Medicine I, University of Vienna, Austria

,

A Stümpflen

²The Department of Internal Medicine II, University of Vienna, Austria

,

M Hirschl

³The Department of Hanuschkrankenhaus, Vienna, Austria

,

C Bialonczyk

⁴The Wilhelminenspital, Vienna, Austria

,

B Schneider

⁵The department of Medical Statistics, University of Vienna, Austria

,

C Mannhalter

⁶Clinical Institute of Medical and Chemical Laboratory Diagnostics, University of Vienna, Austria

,

M Melichart

¹The Department of Internal Medicine I, University of Vienna, Austria

,

G Traxler

¹The Department of Internal Medicine I, University of Vienna, Austria

,

A Weltermann

¹The Department of Internal Medicine I, University of Vienna, Austria

,

W Speiser

⁶Clinical Institute of Medical and Chemical Laboratory Diagnostics, University of Vienna, Austria

,

K Lechner

¹The Department of Internal Medicine I, University of Vienna, Austria

› Author Affiliations

Abstract

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Summary

It would be important to estimate in advance the risk of recurrent thrombosis. Deficiencies of antithrombin, protein C or protein S, or resistance to activated protein C are associated with a biochemically detectable prethrombotic state. It is thus far unknown whether in patients with a history of thromboembolism but without a defined clotting abnormality a heightened coagulation activation is detectable.

We investigated the value of prothrombin fragment Fl+2 (FI+2) as a predictor of recurrent venous thromboembolism. Furthermore, we compared the Fl+2 levels of thrombosis patients without a defined clotting defect to those of Factor V Leiden patients with a history of venous thrombosis and to those of healthy controls. 180 patients without a defined clotting abnormality and 73 patients with Factor V Leiden were prospectively followed after discontinuation of oral anticoagulants for venous thrombosis and Fl+2 was measured at regular intervals.

Recurrent venous thromboembolism occurred in 23 (9%) of the 253 patients. Before or at several time points after oral anticoagulants, no significant difference in Fl+2 levels was found in patients with and without recurrent thrombosis. Fl+2 levels at 3 weeks and prior to recurrence were not significantly different in both patient groups. Over a one-year observation period, Fl+2 levels of both patients with and without Factor V Leiden were higher than those of the controls. No difference in Fl+2 was seen between patients with and without Factor V Leiden.

We conclude that monitoring of Fl+2 is not suitable for identification of individuals at risk of recurrent venous thrombosis. Permanent hemostatic system activation is detectable both in patients with a defined abnormality of the clotting system and in patients in whom a particular defect has not (yet) been identified.

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