Coagulation factor VIII, IX and XI levels in north Indian patients with venous thromboembolism

Abstract

Studies have shown elevated levels of certain coagulation factors as risk factors for venous thromboembolism (VTE). In this study, we investigated the levels of coagulation factor VIII (FVIII), FIX and FXI in north Indian patients with VTE. A total of 123 patients with VTE were screened prospectively for FVIII, FIX and FXI levels and the conventional risk factors - deficiencies of protein C, S and antithrombin, positivity for antiphospholipid antibodies and the factor V Leiden mutation. Age-matched and sex-matched controls were included. VTE was secondary to known circumstantial and thrombophilic risk factors in 66 (53.7%) patients. In 46.3% (idiopathic VTE) patients, no cause was identified. The mean FVIII levels in idiopathic (187 IU/dl) and secondary VTE patients (185.4 IU/dl) were significantly higher compared with controls (129.6 IU/dl; P < 0.001). However, there was no statistically significant difference in the levels of FIX and FXI between patients and controls (P = 0.214 and 0.198, respectively). Patients with elevated FVIII levels had increased risk of VTE compared with controls (odds ratio: 9.4, 95% confidence interval: 4.7-18.79). On logistic regression analysis after adjusting for surgery and presence of antiphospholipid antibodies, this risk remained unchanged (odds ratio: 9.54, 95% confidence interval: 4.68-19.44). A dose-response relationship was observed with progressive increase in FVIII levels. Elevated FVIII levels constitute an independent risk factor for VTE in the north Indian population. Elevated levels of FIX and FXI were not associated with increased risk of VTE.

Marburg I Polymorphism (G511E) in Adults with Deep Vein Thrombosis

“…Five patients had a PS deficiency (10%), and three patients were deficient for AT (6%). The incidence of antiphospholipid antibodies among Indian patients with venous thrombosis ranges from 5.5 to 10% [3,[13][14][15] The present study also had similar incidence (4 cases; 8%). The presence of antiphospholipid antibodies among 6% (3 controls) of controls is uncommon.…”

“…However, the incidence was less among can-Americans and other non-Caucasians [11]. Studies done in the Indian population with venous thrombosis reported the incidence of FVL mutation ranging from 3 to 12% of the patients [3,12,13]. In the present study, FVL mutation was seen in 5 patients (10%) and all were heterozygous.…”

Plasma levels of coagulation factors VIII and IX and risk of venous thromboembolism: Systematic review and meta-analysis

“…Fig. 3 shows the analysis of FVIII per 10 IU/dl categories, performed in the seven studies noted above and in five other published case-control studies [ 12 , 23 – 26 ]. The pooled odds ratio of VTE was 1.11 (1.07, 1.14).…”

Risk of Venous Thrombosis in Antithrombin Deficiency: A Systematic Review and Bayesian Meta-analysis

“…Nineteen studies were used for the OR estimates of the first VTE, containing data on 1,381 antithrombin-deficient individuals and 31,111 controls. 14,15,[17][18][19][21][22][23][24][25][26][27][28][29][31][32][33][34][35] Antithrombin-deficient individuals have an increased risk of a first VTE event as compared with controls, OR 14.0; 95% CrI, 5.5 to 29.0. An increased risk was found for antithrombin deficient individuals in all meta-analyses of subgroups of studies.…”