Thromb Haemost 2007; 98(05): 1040-1044
DOI: 10.1160/TH07-04-0293
Blood Coagulation, Fibrinolysis and Cellular Haemostasis
Schattauer GmbH

Absolute annual incidences of first events of venous thromboembolism and arterial vascular events in individuals with elevated FVIII:c

A prospective family cohort study
Ivan Bank
1   Department of Vascular Medicine, Academic Medical Center, University of Amsterdam
,
Marlène H. W. van de Poel
2   Department of Hematology, Division of Hemostasis, Thrombosis, and Rheology, University Hospital Groningen
,
Michiel Coppens
1   Department of Vascular Medicine, Academic Medical Center, University of Amsterdam
,
Karly Hamulyák
3   Department of Hematology, University Hospital of Maastricht, Maastricht
,
Martin H. Prins
4   Department of Clinical Epidemiology and Medical Technology Assessment, University Hospital of Maastricht, Maastricht; The Netherlands
,
Jan van der Meer
3   Department of Hematology, University Hospital of Maastricht, Maastricht
,
Nic J. G. M. Veeger
3   Department of Hematology, University Hospital of Maastricht, Maastricht
,
Harry R. Büller
1   Department of Vascular Medicine, Academic Medical Center, University of Amsterdam
,
Saskia Middeldorp
1   Department of Vascular Medicine, Academic Medical Center, University of Amsterdam
› Author Affiliations

Financial support: This study was financially supported by a grant from the Dutch Heart Foundation (number 1999.187).
Further Information

Publication History

Received 21 April 2007

Accepted after resubmission 05 September 2007

Publication Date:
30 November 2017 (online)

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Summary

Elevated levels of factor VIII:c (elevated FVIII:c) are associated with an increased risk for venous thromboembolism (VTE) and arterial vascular events, and are at least in part determined genetically. We prospectively followed 192 asymptomatic individuals with elevated FVIII:c (>150%) and 340 with normal levels for an average duration of 31 months (range 7 to 56 months) to investigate the risk of VTE and arterial vascular events. Participants were first degree relatives of consecutive patients with elevated FVIII:c and VTE or arterial vascular events before the age of 50 years. The incidences ofVTE were 1.25% (0.46–2.73) per year in the subjects with elevated FVIII:c, versus 0.23% (0.03–0.82) in those with normal levels (OR 5.5 [1.1–27.3]). The annual incidences of arterial vascular events were 1.04% (0.34–2.42) and 0.23% (0.03–0.82) in relatives with and without elevated levels of FVIII:c, respectively (OR: 4.5 [0.9–23.5]). After adjustment for age, smoking, known diabetes mellitus, hyperlipidemia, and hypertension, the odds ratio for any event was 3.7 (1.1–13.1). In conclusion, asymptomatic individuals with elevated FVIII:c levels and a positive family history of VTE or arterial vascular events before the age of 50 appear to have a high annual incidence of first VTE and arterial vascular events. Elevated FVIII:c may be a common risk factor for both clinical entities.