Elevated factor <scp>VIII</scp> levels and risk of venous thrombosis

Jenkins, P. Vincent; Rawley, Orla; Smith, Owen; O’Donnell, James S.

doi:10.1111/j.1365-2141.2012.09134.x

Cited by 266 publications

(215 citation statements)

References 77 publications

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“…However, the optimal clinical management requires further studies. We suggest that the surrogate markers of coagulation (e.g., fibrinogen, factor VIII, and D-dimer may be valuable in designing antithrombotic medication, as reported in cardiovascular disease and venous thromboembolism (36,37). Against the background of common acquired coagulation abnormalities, thrombophilia and female sex predispose patients with ESRD to problems with patency of the vascular access.…”

Section: Discussionmentioning

confidence: 95%

Thrombophilia and Arteriovenous Fistula Survival in ESRD

Salmela

Hartman²,

Peltonen³

et al. 2013

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives The role of thrombophilia in failing arteriovenous fistula (AVF) among patients with ESRD undergoing hemodialysis is not established. This study aimed to assess whether AVF primary patency is associated with thrombophilia and coagulation abnormalities.Design, setting, participants, & measurements This observational study screened 219 patients between 2002 and 2004 for thrombophilia before AVF surgery. Thrombophilia included factor V Leiden and prothrombin G20210A mutations, protein C and antithrombin activities, and protein S. Coagulation abnormalities included high factor VIII:C, homocysteine, fibrinogen, and D-dimer levels; presence of antiphospholipid antibodies; and short thrombin time. We reviewed patient charts for comorbid conditions, AVF maturation and interventions, kidney transplantation, and patient survival (mean follow-up duration, 3.6 [range, 2.3-5.8] years). Primary patency from the AVF placement and functional primary patency from the first AVF cannulation were analyzed with Kaplan-Meier and Cox proportional hazards models.Results Thrombophilia was present in 9% of the patients, and coagulation abnormalities occurred in 77%. One-year primary patency was 68%; 46% of the AVF failures occurred before the initiation of hemodialysis. Female sex (hazard ratio [HR], 2.6; 95% confidence interval [CI], 1.7-4.1) and thrombophilia (HR, 2.2; 95% CI, 1.2-4.2) were independent risk factors for loss of primary patency. Thrombophilia mutations or low antithrombin level (HR, 3.8), female sex (HR, 2.5), and diabetes (HR, 1.9) were associated with shortened functional primary patency of AVF.Conclusions Against the background of frequent coagulation abnormalities, thrombophilia and female sex predispose patients with ESRD to access failure, mostly due to thrombosis or stenosis.

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Section: Discussionmentioning

confidence: 95%

Thrombophilia and Arteriovenous Fistula Survival in ESRD

Salmela

Hartman²,

Peltonen³

et al. 2013

Clinical Journal of the American Society of Nephrology

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“…5,6 Elevated plasma factor VIII:C levels increase the risk of venous and arterial thrombosis. [7][8][9][10] The increased factor VIII level in the present patient may have contributed to the development of cerebral infarction.…”

Section: Discussionmentioning

confidence: 64%

Untitled

2014

Exp Clin Transplant

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Thromboembolism is a complication of hematopoietic stem cell transplant. However, a literature search showed no previous reports of cerebral infarction during the thrombocytopenic stage after hematopoietic stem cell transplant. A 35-year-old woman with acute lymphoblastic leukemia (precursor B-cell type) was treated with hematopoietic stem cell transplant after induction and consolidation chemotherapy. On day 2 after transplant, she was unconscious, and had urinary incontinence and left hemiplegia. A computed tomography scan of the brain showed an acute ischemic infarct in the right middle cerebral artery region and an old infarct at the left thalamus without atherosclerosis. Factor VIII level was elevated (190%; normal range, 60% to 150%). She was treated with rehabilitation and low-dose aspirin. At 6 months after transplant, the leukemia remained in remission and she had no further thromboembolic events. This case suggests that prudent treatment of patients who have hematopoietic stem cell transplant may include monitoring for thromboembolism and testing factor VIII level before transplant.

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“…8 Other genetic risk factors for VTE are dysfibrinogenemia (FGG, fibrinogen g 0 ), 11 F11 gene, 9 and non-O blood group. [12][13][14] The initial observation that an elevated factor VIII level is a risk factor for venous thrombosis 15 is now supported by robust evidence. Over the past years, research to identify genetic variants associated with VTE focused on hundreds of single-nucleotide polymorphisms.…”

Section: Inherited Thrombophiliamentioning

confidence: 99%

Thrombophilia Screening: Universal, Selected, or Neither?

Colucci

Tsakiris

2017

Clin Appl Thromb Hemost

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The utility of thrombophilia testing in clinical practice is still a matter of debate because studies have not shown a benefit in the reduction of recurrent venous thromboembolism (VTE) risk in patients with thrombosis, despite the clearly higher VTE risk for first thrombosis. Screening for thrombophilia is indicated in selected patients. Particularly in selected young patients, especially women of childbearing age, the knowledge of the genetic thrombophilic defect may help in specific situations to decrease the risk of VTE events. Avoidance of modifiable risk factors and/or prophylactic thromboembolic procedures may be evaluated in selected patients. A comprehensive workup including personal and familial history, clinical examination, and laboratory test results including hereditary thrombophilia remains helpful in assessing the cumulative risk and the management of this group of selected patients.

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Elevated factor VIII levels and risk of venous thrombosis

Cited by 266 publications

References 77 publications

Thrombophilia and Arteriovenous Fistula Survival in ESRD

Thrombophilia and Arteriovenous Fistula Survival in ESRD

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Thrombophilia Screening: Universal, Selected, or Neither?

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