High Plasma Level of Factor VIII  - An Important Risk Factor for Venous Thromboembolism -

Ota, Satoshi; Yamada, Norikazu; Ogihara, Yoshito; Tsuji, Akiko; Ishikura, Ken; Nakamura, Mashio; Wada, Hideo; M, Ito

doi:10.1253/circj.cj-10-1051

Cited by 33 publications

(17 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…D-dimer concentration, a global marker of fibrinolysis associated with future venous thromboembolism (VTE) risk [8, 9], increased approximately 50% after 3 and 6 cycles of all OC regimens [6]. Factor VIII activity, another independent risk factor for VTE [10–15], increased approximately 20% after 3 and 6 cycles [6]. Neither EE2 dose or progestin type had a clear effect on these increases.…”

Section: Introductionmentioning

confidence: 99%

Clotting factor changes during the first cycle of oral contraceptive use

et al. 2016

View full text Add to dashboard Cite

Objectives The risk of venous thromboembolism (VTE) is highest during the initial months of oral contraceptive (OC) use. We sought to evaluate the extent of hemostatic variable changes during the initial OC cycle and if such changes are related to systemic ethinyl estradiol (EE2) exposure. Study Design Participants provided multiple blood samples during a 21-day OC cycle (30 mcg EE2; 150 mcg levonorgestrel) and after a single dose following a wash-out period. Analytes included D-dimer, factor VIII activity, protein C total antigen and the hepatic proteins corticosteroid- and sex-hormone-binding globulins (CBG and SHBG). EE2 pharmacokinetic analyses related to the 24 hours after the first OC tablet (OC1) and at steady state (OC21). Results Seventeen women completed the study. D-dimer more than doubled by OC6 (p = 0.013) and remained elevated at OC21 (p=0.012). D-dimer levels within women varied widely from day-to-day. Factor VIII increased 27% by OC2 (p < 0.001), but declined to a 9% increase by OC21. Protein C increased only 6%. EE2 steady-state area-under-the-curve ranged from 488 to 1103 pg·h/mL; higher levels were not correlated with greater increases in clotting variables. CBG and SHBG increased significantly, but were not significantly correlated with levels of EE2 or with the hemostatic variables. Conclusions D-dimer increases during the first OC cycle were at least as great as increases seen with longer OC use. These results provide support for the increased VTE risk during initial OC use. The extreme variability in D-dimer levels may be an important component of this risk.

show abstract

Section: Introductionmentioning

confidence: 99%

Clotting factor changes during the first cycle of oral contraceptive use

et al. 2016

View full text Add to dashboard Cite

show abstract

“… 33 High factor VIII concentrations represent a risk factor for thrombosis similar to the deficiencies of inhibitors such as proteins C and S and activated protein C resistance. 59 The Austrian Study on Recurrent Venous Thromboembolism 33 demonstrated that the risk of recurrent thrombosis is 7-fold higher among patients with factor VIII levels exceeding the 90th percentile (>234 IU/dL), and this factor also constitutes a risk factor for the development of thrombosis in non-Western populations, as occurs in portal vein thrombosis and DVT in Indian 31 and Japanese 48 populations, respectively.…”

Section: Discussionmentioning

confidence: 99%

High Prevalence of Prothrombotic Abnormalities in Multifocal Osteonecrosis

et al. 2013

View full text Add to dashboard Cite

Multifocal or multiple osteonecrosis (ON), defined by the involvement of 3 or more anatomic sites, is unusual, being observed in only 3%–10% of patients diagnosed with ON. We report the clinical characteristics of a cohort of 29 patients with multifocal ON from a single center and evaluate the prevalence of associated prothrombotic abnormalities in 26 of these patients. We conducted a retrospective study of all patients diagnosed with multifocal ON evaluated in our institution during the last 20 years. We recorded clinical manifestations and underlying diagnoses. A wide thrombophilic profile was performed, including antithrombin, protein C, protein S, lupus anticoagulant, anticardiolipin antibodies, activated protein C resistance, factor V Leiden, mutation G-20210-A of the prothrombin gene, and factor VIII. Coagulation test results were compared with those in a healthy control group and a group of patients with history of lower-extremity deep venous thrombosis.The mean age of the patients was 49.2 ± 15 years (range, 28–81 yr). The mean number of ON localizations per patient was 5.2 ± 2.3 (range, 3–11). Hips were the most commonly affected joint (82%), followed by knees (58%), shoulders (37%), and ankles (13%). Most patients had an underlying disease process, and 12 of 25 (48%) patients had coagulation test abnormalities. The most common alterations were high factor VIII levels and antiphospholipid antibody (aPL) positivity in 24% and 20% of cases, respectively. These abnormalities were more prevalent in patients with multifocal ON compared with patients in the control groups.Sixty-one percent of patients had a history of corticosteroid treatment. Patients with coagulation abnormalities had a higher number of ON localizations per patient (6.5 ± 2.7 vs. 3.88 ± 0.8; p = 0.002) and a higher prevalence of atypical ON localizations (25% vs. 0%; p = 0.05).In conclusion, in the present cohort of patients with multifocal ON, 48% of the patients had at least 1 prothrombotic factor, especially high levels of factor VIII and aPL. These findings have major implications for the diagnosis and treatment of multifocal ON and clearly indicate the need to perform a thrombophilic profile in these patients.

show abstract

“…Several studies have demonstrated an association between elevated factor VIII and increased risk of thrombophilia, partly due to factor VIII-mediated enhancement of thrombin generation [57, 58, 59, 60]. Although no genetic variations in the factor VIII gene have been identified, levels appear to be higher in African-Americans and lower in individuals with blood group O.…”

Section: Specific Hypercoagulable Disorders and Laboratory Studiesmentioning

confidence: 99%

Hypercoagulable states: an algorithmic approach to laboratory testing and update on monitoring of direct oral anticoagulants

Nakashima

Rogers

2014

Blood Res

View full text Add to dashboard Cite

Hypercoagulability can result from a variety of inherited and, more commonly, acquired conditions. Testing for the underlying cause of thrombosis in a patient is complicated both by the number and variety of clinical conditions that can cause hypercoagulability as well as the many potential assay interferences. Using an algorithmic approach to hypercoagulability testing provides the ability to tailor assay selection to the clinical scenario. It also reduces the number of unnecessary tests performed, saving cost and time, and preventing potential false results. New oral anticoagulants are powerful tools for managing hypercoagulable patients; however, their use introduces new challenges in terms of test interpretation and therapeutic monitoring. The coagulation laboratory plays an essential role in testing for and treating hypercoagulable states. The input of laboratory professionals is necessary to guide appropriate testing and synthesize interpretation of results.

show abstract

High Plasma Level of Factor VIII - An Important Risk Factor for Venous Thromboembolism -

Cited by 33 publications

References 29 publications

Clotting factor changes during the first cycle of oral contraceptive use

Clotting factor changes during the first cycle of oral contraceptive use

High Prevalence of Prothrombotic Abnormalities in Multifocal Osteonecrosis

Hypercoagulable states: an algorithmic approach to laboratory testing and update on monitoring of direct oral anticoagulants

Contact Info

Product

Resources

About