The Risk of Recurrent Venous Thromboembolism in Patients with and without Factor V Leiden
The Risk of Recurrent Venous Thromboembolism in Patients with and without Factor V Leiden
复制标题
有或没有 V 因子 Leiden 的患者复发静脉血栓栓塞的风险
作者：
S. Eichinger;I. Pabinger;Andreas Stümpfien;M. Hirschl;C. Bialonczyk;B. Schneider;C. Mannhalter;E. Minar;K. Lechner;P. Kyrle
在首次静脉血栓栓塞事件（VTE）后，已确立了长达6个月的口服抗凝剂血栓预防。此后复发性VTE的风险仍然相当大，并且不确定某些患者是否可以从延长抗凝治疗中获益。我们进行了一项前瞻性、多中心试验（4个血栓形成中心），评估了380例首次或复发性VTE患者（排除了抗凝血酶、蛋白C、蛋白S或纤溶酶原缺乏、癌症或抗磷脂抗体综合征患者）在停用口服抗凝剂进行二级血栓预防后复发的风险。本研究的目的是评估莱顿凝血因子V患者复发性VTE的风险是否增加。112例（29.5%）患者为莱顿因子V携带者（26.9%杂合子，2.6%纯合子）。中位观察时间为19.3个月后，VTE的总体复发率为9.9%。268例无凝血因子V Leiden的患者中有26例（9.7%）和112例凝血因子V Leiden的患者中有10例（8.9%）发生复发性深静脉血栓形成和/或肺栓塞。停用口服抗凝剂后2年，无凝血因子V Leiden的患者复发VTE的概率为12.4%（95%CI 7.8-17），突变携带者为10.6%（95%CI 3.8-17.4）。该差异在统计学上不显著。在停用口服抗凝剂后的两年内，莱顿凝血因子V患者复发VTE的风险并不高于莱顿凝血因子V患者。平衡复发性VTE和口腔出血的风险。抗凝剂，凝血因子V莱顿患者不太可能受益于口服抗凝剂治疗超过6个月。
Summary Thromboprophylaxis with oral anticoagulants up to six months is established in patients after a first venous thromboembolic event (VTE). The risk of recurrent VTE is still considerable thereafter, and it is uncertain whether some patients might benefit from extended anticoagulation. We performed a prospective, multicenter trial (4 thrombosis centers) and evaluated in 380 patients with a first or recurrent VTE (patients with a deficiency of antithrombin, protein C, protein S or plasminogen; cancer; or an antiphospholipid antibody syndrome were excluded) the risk of recurrence after discontinuation of secondary thromboprophylaxis with oral anticoagulants. It was the aim of the study to evaluate whether patients with factor V Leiden are at an increased risk of recurrent VTE. 112 (29.5%) patients were carriers of factor V Leiden (26.9% heterozygous, 2.6% homozygous). After a median observation time of 19.3 months the overall recurrence rate of VTE was 9.9%. Recurrent deep vein thrombosis and/or pulmonary embolism occurred in 26 of 268 patients without factor V Leiden (9.7%) and in 10 of 112 patients with factor V Leiden (8.9%). The probability of recurrent VTE two years after discontinuation of oral anticoagulants was 12.4% (95% Cl 7.8-17) in patients without factor V Leiden and was 10.6% (95% Cl 3.8-17.4) in carriers of the mutation. This difference was statistically not significant. Patients with factor V Leiden are not at a higher risk of recurrent VTE within two years after discontinuation of oral anticoagulants than patients without factor V Leiden. Balancing the risk of recurrent VTE and bleeding from oral. anticoagulants, patients with factor V Leiden are not likely to benefit from oral anticoagulant therapy extended beyond six months.
静脉血栓形成倾向中凝血因子 Va 异常与活化蛋白 C 抵抗相关。
影响因子：
20.3
作者：
Sun,X;Evatt,B;Griffin,JH
通讯作者：
Griffin,JH