High frequency of factor V Leiden in surgical patients with symptomatic venous thromboembolism despite prophylaxis

Mohamed Baba-Ahmed; Grégoire Le Gal; Francis Couturaud; Karine Lacut; Emmanuel Oger; Christophe Leroyer

doi:10.1160/TH06-11-0616

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2007; 97(02): 171-175
DOI: 10.1160/TH06-11-0616

Blood Coagulation, Fibrinolysis and Cellular Haemostasis

Schattauer GmbH

High frequency of factor V Leiden in surgical patients with symptomatic venous thromboembolism despite prophylaxis

Mohamed Baba-Ahmed

¹From the G.E.T.B.O (Groupe d’Etude de la Thrombose de Bretagne Occidentale), Equipe d’Accueil 38 78, Department of Internal Medicine and Chest Diseases, Brest University Hospital, Brest, France

,

Grégoire Le Gal

¹From the G.E.T.B.O (Groupe d’Etude de la Thrombose de Bretagne Occidentale), Equipe d’Accueil 38 78, Department of Internal Medicine and Chest Diseases, Brest University Hospital, Brest, France

,

Francis Couturaud

¹From the G.E.T.B.O (Groupe d’Etude de la Thrombose de Bretagne Occidentale), Equipe d’Accueil 38 78, Department of Internal Medicine and Chest Diseases, Brest University Hospital, Brest, France

,

Karine Lacut

¹From the G.E.T.B.O (Groupe d’Etude de la Thrombose de Bretagne Occidentale), Equipe d’Accueil 38 78, Department of Internal Medicine and Chest Diseases, Brest University Hospital, Brest, France

,

Emmanuel Oger

¹From the G.E.T.B.O (Groupe d’Etude de la Thrombose de Bretagne Occidentale), Equipe d’Accueil 38 78, Department of Internal Medicine and Chest Diseases, Brest University Hospital, Brest, France

,

Christophe Leroyer

¹From the G.E.T.B.O (Groupe d’Etude de la Thrombose de Bretagne Occidentale), Equipe d’Accueil 38 78, Department of Internal Medicine and Chest Diseases, Brest University Hospital, Brest, France

› Author Affiliations

Abstract

Summary

Among candidate risk factors associated with postoperative venous thromboembolism (VTE), the role of factorV Leiden (FVL) mutation remains unclear. We performed a case-control study to assess the potential significance of FVL mutation in postoperative VTE cases despite prophylaxis. We used data from the ongoing case-control “EDITH” study. We extracted 133VTE cases and 144 controls who had undergone either surgery or had plaster cast in the previous three months. Prophylaxis adequacy with regard to the recommendations published by theAmerican College of Chest Physicians was retrospectively assessed. FVL mutation was present in 20VTE cases and four controls (OR 5.9, 95% CI 2–18). Prophylaxis was judged as adequate in 116 cases (88.5 %) and in 129 controls (87.2 %) (p = 0.66). The frequency of FVL mutation was not different in VTE cases occurring while on adequate prophylaxis and in VTE cases occurring after the end of adequate prophylaxis (p = 0.27). FVL mutation was closely associated with postoperative VTE in patients classified as having received an adequate prophylaxis (8.4; 95% CI, 2.4 to 29). This study shows a close association between the presence of factorV Leiden mutation in symptomaticVTE occurring after surgery despite prophylaxis.

Keywords

Venous thromboembolism - pulmonary embolism - factor V Leiden - surgery - orthopaedic surgery - risk factors

Full Text

References

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