The risk of symptomatic pulmonary embolism due to proximal deep venous thrombosis differs in patients with different types of inherited thrombophilia

Elena Rossi; Tommaso Za; Angela Ciminello; Giuseppe Leone; Valerio De Stefano

doi:10.1160/TH08-02-0069

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2008; 99(06): 1030-1034
DOI: 10.1160/TH08-02-0069

Blood Coagulation, Fibrinolysis and Cellular Haemostasis

Schattauer GmbH

The risk of symptomatic pulmonary embolism due to proximal deep venous thrombosis differs in patients with different types of inherited thrombophilia

Elena Rossi

¹Institute of Hematology, Catholic University, Rome, Italy

,

Tommaso Za

¹Institute of Hematology, Catholic University, Rome, Italy

,

Angela Ciminello

¹Institute of Hematology, Catholic University, Rome, Italy

,

Giuseppe Leone

¹Institute of Hematology, Catholic University, Rome, Italy

,

Valerio De Stefano

¹Institute of Hematology, Catholic University, Rome, Italy

› Author Affiliations

Abstract

Summary

It is uncertain whether the presence of inherited thrombophilia influences the risk of developing symptomatic pulmonary embolism (PE) and whether different thrombophilic alterations are associated with different risks of symptomatic PE. To investigate such issue, we retrospectively studied 920 patients with proximal deep vein thrombosis (DVT) of the legs with or without symptomatic PE referred for thrombophilia screening; patients with overt cancer or antiphospholipid antibodies had been excluded. Three hundred fifty-four patients (38.5%) had deficiency of antithrombin (AT, n=16), protein C (PC, n=26), protein S (PS, n=22), factor V Leiden (FVL, n=168), prothrombin G20210A (PT-GA, n=87), or multiple abnormalities (n=35), and 566 had none of the studied thrombophilic abnormalities. Symptomatic PE complicated the first DVT in 242 patients (26%); the risk of PE was increased in patients with AT deficiency (relative risk [RR] 2.4, 95% confidence interval [CI] 1.6–3.6) or with PT-GA (RR 1.5, 95%CI 1.1–2.0) and decreased in those with FVL (RR 0.7, 95%CI 0.5–1.0) in comparison with those with unknown inherited defect. These data suggest that patients with proximal DVT have different risks of symptomatic PE according to the type of inherited thrombophilia.

Keywords

Venous thrombosis - pulmonary embolism - antithrombin deficiency - factor V Leiden - prothrombin G20210A

Full Text

References

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