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Thromb Haemost 2013; 109(03): 510-516
DOI: 10.1160/TH12-01-0041
Blood Coagulation, Fibrinolysis and Cellular Haemostasis
Schattauer GmbH

The influence of factor V Leiden and G20210A prothrombin mutation on the presence of residual vein obstruction after idiopathic deep-vein thrombosis of the lower limbs

Benilde Cosmi
1   Department of Angiology & Blood Coagulation “Marino Golinelli”, University Hospital S. Orsola-Malpighi, Bologna, Italy
,
Cristina Legnani
1   Department of Angiology & Blood Coagulation “Marino Golinelli”, University Hospital S. Orsola-Malpighi, Bologna, Italy
,
Vittorio Pengo
2   Department of Clinical and Experimental Medicine, Division of Clinical Cardiology, University Hospital, Padua Italy
,
Angelo Ghirarduzzi
3   Department of Internal Medicine I, Angiology, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy
,
Sophie Testa
4   Haemostasis & Thrombosis Center, General Hospital, Cremona, Italy
,
Daniela Poli
5   Azienda Ospedaliera di Careggi and Universita’ di Firenze, Florence, Italy
,
Domenico Prisco
5   Azienda Ospedaliera di Careggi and Universita’ di Firenze, Florence, Italy
,
Armando Tripodi
6   Angelo Bianchi Bonomi Hemophilia & Thrombosis Center, Department of Internal Medicine, University & IRCCS Maggiore Hospital, Milan, Italy
,
Gualtiero Palareti
1   Department of Angiology & Blood Coagulation “Marino Golinelli”, University Hospital S. Orsola-Malpighi, Bologna, Italy
,
for the PROLONG Investigators FCSA, Italian Federation of Anticoagulation Clinics › Author Affiliations
Further Information

Publication History

Received: 26 January 2012

Accepted after major revision: 14 January 2012

Publication Date:
29 November 2017 (online)

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Summary

It was our aim to assess whether factor V Leiden (FVL) and G20210A prothrombin (FII) mutation are associated with the presence of residual vein obstruction (RVO) after a standard course of anticoagulation for a first episode of idiopathic proximal deep-vein thrombosis (DVT) of the lower limbs, with or without symptomatic pulmonary embolism (PE). Patients were enrolled in two prospective multicentre studies: PROLONG and PROLONG II. RVO was detected by compression ultra-sonography according to the method of Prandoni on the day of anticoagulation withdrawal. Patients were also screened for FVL and FII mutation. The presence of FVL and/or FII mutation was determined in 872/963 (90.5%) patients, in 753 of whom RVO was assessed. FVL was significantly less frequent among subjects with isolated PE (7/176:4%) than among patients with either DVT and PE (15/133:11.3%; p=0.0018) or isolated DVT (89/563:15.8%; p<0.0001), confirming the FVL paradox. The rate of FII mutation was similar among patients with isolated PE (11/176:6.2%) and patients with either DVT and PE (12/133:9%) or isolated DVT (52/563:9.2%). FVL and FII mutation were not significantly associated with RVO at the multivariate analysis in all patients, although data suggest that FVL and FII mutation may have a differential effect on RVO in the subgroups of patients with DVT and DVT plus PE patients. Male sex and isolated DVT were significantly associated with RVO in all patients. In conclusion, male sex and isolated DVT are associated with RVO, while FVL and FII mutations are not significantly associated with RVO in this study.

Keywords

Deep-vein thrombosis - pulmonary embolism - thrombophilia - venous thrombosis - residual vein obstruction

* The PROLONG and Prolong II investigators are listed in Appendix ClinicalTrials.gov number NCT00264277 and NCT00266045.


 

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