Is APC Resistance a Risk Factor for Venous Thromboembolism in Patients over 70 Years?

Emmanuel Oger; Karine Lacut; Grégoire Le Gal; Patrick Van Dreden; Luc Bressollette; Pierre-Yves Scarabin; Christophe Leroyer; Dominique Mottier

doi:10.1055/s-0037-1613260

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2002; 88(04): 587-591
DOI: 10.1055/s-0037-1613260

Review Article

Schattauer GmbH

Is APC Resistance a Risk Factor for Venous Thromboembolism in Patients over 70 Years?

Emmanuel Oger

¹G. E.T. B. O. (Groupe d’Etude de la Thrombose de Bretagne Occidentale), Department of Internal Medicine and Chest Diseases, Hôpital de la Cavale Blanche, Brest

,

Karine Lacut

¹G. E.T. B. O. (Groupe d’Etude de la Thrombose de Bretagne Occidentale), Department of Internal Medicine and Chest Diseases, Hôpital de la Cavale Blanche, Brest

,

Grégoire Le Gal

¹G. E.T. B. O. (Groupe d’Etude de la Thrombose de Bretagne Occidentale), Department of Internal Medicine and Chest Diseases, Hôpital de la Cavale Blanche, Brest

,

Patrick Van Dreden

²Serbio (Diagnostica Stago), Gennevilliers

,

Luc Bressollette

¹G. E.T. B. O. (Groupe d’Etude de la Thrombose de Bretagne Occidentale), Department of Internal Medicine and Chest Diseases, Hôpital de la Cavale Blanche, Brest

,

Pierre-Yves Scarabin

³INSERM Unit 258, Villejuif, France

,

Christophe Leroyer

¹G. E.T. B. O. (Groupe d’Etude de la Thrombose de Bretagne Occidentale), Department of Internal Medicine and Chest Diseases, Hôpital de la Cavale Blanche, Brest

,

Dominique Mottier

¹G. E.T. B. O. (Groupe d’Etude de la Thrombose de Bretagne Occidentale), Department of Internal Medicine and Chest Diseases, Hôpital de la Cavale Blanche, Brest

› Author Affiliations

Abstract

Summary

Activated protein C (APC) resistance is the most common risk factor for venous thromboembolism (VTE). Previous studies mostly analysed patients under 70 years and reported a four-to sevenfold increased risk. This case-control study included consecutive patients referred for a clinical suspicion VTE to our medical unit: 621 patients with a well-documented diagnosis (cases) and 406 patients for which the diagnosis was ruled out and who had no personal history of VTE (controls). APC resistance related to factor V Leiden was defined by either a positive DNA analysis or a positive STA^® Staclot APC-R assay. Under 70 years, APC resistance was associated with a threefold increased risk of VTE (odds ratio 3.2, 95% CI, 1.7 to 6.0), whereas in patients over 70 years, it appeared to be no longer a strong risk factor (odds ratio 0.8, 95% CI, 0.4 to 1.7). Age appeared as an effectmeasure modifier with a significant interaction (p = 0.005). Our data suggest that APC resistance is not a risk factor for VTE in elderly.

Keywords

APC resistance - venous thrombosis - elderly

Full Text

References

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