The incidence of venous thromboembolism in asymptomatic carriers of a deficiency of antithrombin, protein C, or protein S: a prospective cohort study.
The incidence of venous thromboembolism in asymptomatic carriers of a deficiency of antithrombin, protein C, or protein S: a prospective cohort study.
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抗凝血酶、蛋白 C 或蛋白 S 缺乏的无症状携带者静脉血栓栓塞的发生率：一项前瞻性队列研究。
作者：
B. Sanson;P. Simioni;D. Tormene;M. Moia;P. Friederich;M. Huisman;P. Prandoni;A. Bura;L. Rejtő;P. Wells;P. Mannucci;A. Girolami;H. Büller;M. Prins
抗凝血酶、蛋白 C 和蛋白 S 的缺乏与静脉血栓栓塞风险增加相关。本研究的目的是前瞻性评估具有这种缺陷的未经治疗的无症状受试者中静脉血栓栓塞的发生率。我们对未经选择的出现静脉血栓栓塞事件的患者的无症状家庭成员进行了一项前瞻性队列研究，这些患者被发现缺乏抗凝血酶、蛋白 C 或蛋白 S。除了静脉血栓栓塞的危险期外，研究参与者没有接受抗凝预防。所有静脉血栓栓塞事件均通过客观诊断测试诊断。该研究共有 208 名平均年龄为 37 岁（范围为 15 至 79 岁）的个体。总共获得了 611 个患者观察年。发生了 9 起静脉血栓栓塞事件，这 3 种缺陷的年发生率为 1.5%（95% 置信区间 [CI]，0.7 至 2.8）。其中 5 起事件是自发发生的，导致自发性静脉血栓栓塞的年发生率为 0.8%（95% CI，0.3 至 1.9）。对于抗凝血酶、蛋白 C 和蛋白 S 缺乏，该数字分别为 1.6%、1.0% 和 0.4%。 34 名受试者总共经历了 40 个风险期，其中发生 4 次静脉血栓栓塞事件（每个风险期 10%）。我们的结论是，对于抗凝血酶、蛋白 C 或蛋白 S 缺乏的无症状个体，似乎没有必要使用持续的抗凝预防。在静脉血栓栓塞的危险期，充分的抗凝预防是必要的。
Deficiencies of antithrombin, protein C, and protein S are associated with an increased risk of venous thromboembolism. The objective of this study was to prospectively assess the incidence of venous thromboembolism in nontreated asymptomatic subjects with such a deficiency. We conducted a prospective cohort study in asymptomatic family members of unselected patients who presented with a venous thromboembolic event and who were found to have a deficiency of antithrombin, protein C, or protein S. No anticoagulant prophylaxis was given to the study participants, except during risk periods for venous thromboembolism. All venous thromboembolic events were diagnosed by objective diagnostic tests. A total of 208 individuals with a mean age of 37 years (range, 15 to 79) were included in the study. A total of 611 patient observation years was obtained. Nine venous thromboembolic events occurred, resulting in an annual incidence of 1.5% (95% confidence interval [CI], 0.7 to 2.8) for the 3 deficiencies combined. Five of these events occurred spontaneously, resulting in an annual incidence of spontaneous venous thromboembolism of 0.8% (95% CI, 0.3 to 1.9). For antithrombin, protein C, and protein S deficiencies separately, this figure was 1.6%, 1.0%, and 0.4%, respectively. Thirty-four subjects experienced a total of 40 risk periods during which 4 venous thromboembolic events occurred (10% per risk period). We conclude that the use of continuous anticoagulant prophylaxis seems not warranted in asymptomatic individuals with a deficiency of antithrombin, protein C, or protein S. During risk periods for venous thromboembolism, adequate anticoagulant prophylaxis is necessary.
影响因子：
158.5
作者：
COMP, PC;ESMON, CT
通讯作者：
ESMON, CT