Elevated Clotting Factor Levels and Venous Thrombosis

Bertina, Rogier M.

doi:10.1159/000083835

Cited by 56 publications

(39 citation statements)

References 73 publications

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“…Increased levels of coagulation factors, particularly factor VIII, von Willebrand factor, factor VII and prothrombin are associated with an increased risk of thrombosis, reviewed in 2,35 . The increased risk of thrombosis with the elevation in factor VIII may be due to its inherent instability following activation and hence the need for replenishment to obtain a stable thrombus.…”

Section: A Changes In Blood Coaguabilitymentioning

confidence: 99%

Basic mechanisms and pathogenesis of venous thrombosis

2009

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In 1856 Virchow proposed a triad of causes for venous thrombosis, postulating that stasis, changes in the vessel wall or changes in the blood could lead to thrombosis. We now know that abnormally high levels of some coagulation factors and defects in the natural anticoagulants contribute to thrombotic risk. Among these, factor V Leiden, which renders factor Va resistant to activated protein C, is the most prevalent with approximately 5% of the Caucasian population having this genetic alteration. These genetically controlled variants in coagulation factors work in concert with other risk factors, such as oral contraceptive use, to dramatically increase thrombotic risk. While these abnormalities in the blood coagulation proteins are associated with thrombotic disease propensity, they are less frequent contributors to thrombosis than age or cancer. Cancer increases thrombotic risk by producing tissue factor to initiate coagulation, by shedding procoagulant lipid microparticles or by impairing blood flow. Age is the strongest risk factor for thrombosis. Among possible reasons are fragility of the vessels potentially contributing to stasis, increased coagulation factor levels, impaired function of the venous valves, decreases in the efficacy of natural anticoagulants associated with the vessel wall, increased risk of immobilization and increased risk of severe infection.

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Section: A Changes In Blood Coaguabilitymentioning

confidence: 99%

Basic mechanisms and pathogenesis of venous thrombosis

2009

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“…Recent reviews of the epidemiological literature have concluded that testing of these hypotheses, while showing some promising results, still has a long way to go. 2,3 At present, increased levels of the von Willebrand factor: factor VIII complex show the most consistent associations with both venous and arterial thrombosis, in both case-control and prospective studies. [2][3][4][5][6] For the moment, the causality of these associations cannot be tested, because there are no drug or other interventions which selectively reduce levels of von Willebrand factor (VWF) or factor VIII.…”

mentioning

confidence: 79%

Factor IX and deep vein thrombosis

Lowe¹

2009

Haematologica

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“…Increased plasma levels of factors VIII (FVIII) and IX (FIX) have been reported to be independent risk factors for VTE (8). It is well known that FIX levels increase with age (9).…”

Section: Discussionmentioning

confidence: 99%

Elevated preoperative plasma D-dimer levels and the incidence of venous thromboembolism in Japanese females with gynecological cancer

Kodama

Seki²,

Fukushima³

et al. 2012

Oncology Letters

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Abstract. The purpose of the present study was to determine the incidence of increased levels of D-dimer and associated factors in preoperative patients with gynecological cancer. Furthermore, we determined the incidence and risk factors associated with preoperative venous thromboembolism (VTE). Overall, 456 patients with invasive gynecological cancer scheduled to undergo surgery were recruited. Preoperative plasma D-dimer levels were measured and patients whose plasma D-dimer concentration exceeded the pre-set cut-off value underwent computed tomography scanning. The incidence of elevated D-dimer and VTE was identified as significantly higher in patients with ovarian cancer. Multivariate analysis revealed that advanced age, low hemoglobin levels and elevated C-reactive protein (CRP) levels were independent factors for preoperative elevations in plasma D-dimer levels. Advanced age was an independent risk factor for preoperative VTE. Massive ascites and the presence of co-morbidities were independent risk factors for preoperative VTE in ovarian cancer. Advanced age and stage were independent risk factors for preoperative VTE in endometrial cancer. Advanced age was an independent risk factor for preoperative VTE in cervical cancer. Plasma D-dimer levels and the incidence of preoperative VTE were higher in patients with ovarian cancer compared with those with other gynecological cancers. Advanced age, low hemoglobin levels and elevated CRP levels were significant factors associated with elevated plasma D-dimer levels and age was an independent risk factor for preoperative VTE in gynecological cancer. IntroductionCancer is a widely accepted risk factor for venous thromboembolism (VTE) and, to a lesser extent, arterial thrombosis. This risk is attributed to numerous factors, including expression of prothrombotic factors by tumors, tumor compression of vessels, inflammatory host response to malignancies, immobility, surgery, indwelling central venous catheters and specific antitumor therapies (1). VTE is a common complication of surgery for gynecological cancer and individuals with gynecological malignancies are classified as the highest risk group (2,3). It has been reported that 90% of pulmonary thromboemboli (PTEs) result from deep venous thromboses (DVTs) (4). VTE may occur prior to surgery, due to the hypercoagulable state well-described in cancer patients (3,4). Subclinical VTE may progress and only manifest clinically following surgery. Therefore, it is important to perform preoperative VTE screening for gynecological cancer patients in order to prevent postoperative symptomatic PTE.D-dimer, a marker of a hypercoagulable state, is a stable end-product of fibrin degradation and its levels increase as a result of fibrin formation and fibrinolysis. Measurement of plasma D-dimer levels is often performed during screening for VTE.The aim of the present study was to determine the incidence of increased D-dimer levels and the associated factors in preoperative patients with invasive gynecological cancer. Furthermore, ...

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Elevated Clotting Factor Levels and Venous Thrombosis

Cited by 56 publications

References 73 publications

Basic mechanisms and pathogenesis of venous thrombosis

Basic mechanisms and pathogenesis of venous thrombosis

Factor IX and deep vein thrombosis

Elevated preoperative plasma D-dimer levels and the incidence of venous thromboembolism in Japanese females with gynecological cancer

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