Hyperhomocysteinemia and venous thromboembolism: a risk factor more prevalent in the elderly and in idiopathic cases

Hainaut, Philippe; Jaumotte, C; Verhelst, David; Wallemacq, Pierre; Gala, Jean‐Luc; Lavenne, E.; Heusterspreute, Michel; Zech, Francis; Moriau, M

doi:10.1016/s0049-3848(02)00096-8

Cited by 34 publications

(29 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Additionally, thrombophilia, including the factor V Leiden mutation and the prothrombin gene mutation, was identified in about 18% of subjects, consistent with published studies investigating the prevalence of thrombophilia in unprovoked VTE [8,23]. The prevalence of hyperhomocysteinemia in the current cohort was about 12%, similar to other epidemiologic reports [24]. …”

Section: Discussionsupporting

confidence: 90%

A pilot study utilizing whole body 18 F-FDG-PET/CT as a comprehensive screening strategy for occult malignancy in patients with unprovoked venous thromboembolism

Rondina¹,

Wanner²,

Pendleton³

et al. 2012

Thrombosis Research

View full text Add to dashboard Cite

Background Approximately 7-10% of patients with unprovoked VTE will be diagnosed with cancer within 12 months. Although cancer screening has been proposed in these patients, the optimal strategy remains unclear. In a pilot study, we prospectively investigated the use of FDG-PET/CT to screen for occult malignancy in 40 patients with unprovoked VTE. Materials/Methods Patients were initially screened for occult malignancy with a focused history, physical, and laboratory evaluation. Patients underwent whole body FDG-PET/CT and were followed for up to two years for a new diagnosis of cancer. The total costs of using FDG-PET/CT as a comprehensive screening strategy were determined using 2010 Medicare reimbursement rates. Results Completion of FDG-PET/CT imaging was feasible and identified abnormal findings requiring additional evaluations in 62.5% of patients. Occult malignancy was evident in only one patient (cancer incidence 2.5%) and FDG-PET/CT imaging excluded malignancy in the remainder of patients. No patients with a negative FDG-PET/CT were diagnosed with malignancy during an average (±SD) follow-up of 449 (±311) days. The use of FDG-PET/CT to screen for occult malignancy added $59,151 in total costs ($1,479 per patient). The majority of these costs were due to the cost of the FDG-PET/CT ($1,162 per patient or 78.5% of total per-patient costs). Conclusions FDG-PET/CT may have utility for excluding occult malignancy in patients with unprovoked VTE. The costs of this comprehensive screening strategy were comparable to other screening approaches. Larger studies are needed to further evaluate the utility and cost-effectiveness of FDG-PET/CT as a cancer screening strategy in patients with unprovoked VTE.

show abstract

Section: Discussionsupporting

confidence: 90%

A pilot study utilizing whole body 18 F-FDG-PET/CT as a comprehensive screening strategy for occult malignancy in patients with unprovoked venous thromboembolism

Rondina¹,

Wanner²,

Pendleton³

et al. 2012

Thrombosis Research

View full text Add to dashboard Cite

show abstract

“…A prevalência da hiper-homocisteinemia em pacientes com trombose venosa profunda varia de 11,2% a 25%. Segundo dados da literatura, 16,17,18 o risco de trombose é variável, tendo sido detectado risco relativo (RR) igual a 2,7 (1,3-5,8), com p = 0.009. Mostram ainda como fatores de risco a redução dos níveis da proteína C, aumento da idade e maior incidência no sexo masculino.…”

unclassified

Freqüência da mutação 844ins68 do gene da cistationina beta-sintetase em pacientes com trombose venosa profunda

Bonini-Domingos¹,

Zamaro²,

Mendiburu³

et al. 2005

Rev. Bras. Hematol. Hemoter.

View full text Add to dashboard Cite

Rev. bras. hematol. hemoter. 2005;27(1):12-15 Bonini-Domingos CR et al Artigo / ArticleFreqüência da mutação 844ins68 do gene da cistationina β β β β β-sintetase em pacientes com trombose venosa profunda Frequency of the 844ins68 mutation on the cystathionine β β β β β-synthetase gene in deep venous thrombosis patients Claudia 2212392; Fax (17)2212390 E-mail: laboratorio_hgdh@yahoo.com.br; WebSite: www.lhgdh.ibilce.unesp.br 13 Bonini-Domingos CR et al Rev. bras. hematol. hemoter. 2005;27(1):12-15 Introdução A homocisteína é um derivado da metionina cuja concentração é influenciada por fatores genéticos, nutricionais e patológicos. A hiper-homocisteinemia, mecanismo de hipercoagulabilidade, resulta de alterações funcionais das enzimas envolvidas no metabolismo da metionina ou da deficiência de co-fatores enzimáticos como as vitaminas B6 e B12 e o ácido fólico. Entre as causas hereditárias da hiperhomocisteinemia destacam-se a deficiência funcional da cistationina β-sintetase (CBS) e a variante termolábil da metileno tetra-hidrofolato redutase (MTHFR). 1,2,3A deficiência na conversão da homocisteína em cistationina constitui fator de risco isolado para doenças vasculares, incluindo a doença arterial coronariana, 4,5 o tromboembolismo venoso 6,7 e o acidente cerebral vascular. 8Estudos de meta-análi-se têm reforçado a importância da hiper-homocisteinemia como fator de risco para o tromboembolismo venoso. 9,10,11 Embora o diagnóstico laboratorial da hiperhomocisteinemia possa ser realizado por imunoensaio ou cromatografia, as alterações nos genes CBS e MTFHR somente podem ser analisadas por métodos moleculares. 12Diante da importância que tem sido atribuída à hiper-homocisteinemia como fator de risco para doenças tromboembólicas, o objetivo deste estudo foi avaliar a freqüência da mutação 844ins68 do gene da cistationina β-sintetase em pacientes com trombose venosa profunda, da região noroeste do estado de São Paulo. Casuística e MétodoPara verificar a freqüência da mutação 844ins68 no éxon 8 do gene da cistationina β-sintetase foram avaliados em estudo caso-controle, 95 pacientes com trombose venosa profunda, e um grupo controle com 95 doadores de sangue de São José do Rio Preto, sem história familiar prévia de trombose venosa, com sexo, grupo étnico e idades pareados aos do grupo de estudo. Como critério de inclusão dos pacientes foi adotada a presença de trombose venosa profunda confirmada pelo dúplex ou flebografia. Foram excluídos os pacientes que apresentaram fatores de risco conhecidos como a imobilização, cirurgias, traumas e uso de anticoncepcional. Todos os participantes expressaram consentimento livre e esclarecido e declararam a sua ancestralidade quanto à etnia a ser considerada.Foram coletados cinco mL de sangue venoso, com o uso de anticoagulante EDTA, de cada participante. O DNA foi extraído dos leucócitos pelo mé-todo DTAB e CTAB. 13A detecção da mutação 844ins68 do gene da cistationina β-sintetase consistiu na amplificação de segmento gênico por PCR, com iniciadores que flanqueiam a...

show abstract

“…An elevated plasma level of total homocysteine (tHcy) is an independent risk factor for arterial and venous thrombosis [25][26][27][28]. In our study we found that the plasma tHcy level 12.6 ± 5.7 lmol/L) was significantly higher in patients with SS than the control group (7.2 ± 4.4 lmol/L) (P \ 0.001).…”

Section: Discussionmentioning

confidence: 57%

Analysis of thrombophilic genetic mutations in patients with Sheehan`s syndrome: is thrombophilia responsible for the pathogenesis of Sheehan`s syndrome?

et al. 2010

View full text Add to dashboard Cite

The gene mutations of Factor V R506Q (FV-Leiden), prothrombin (FII G20210A), methylene tetrahydrofolate reductase (MTHFR) C677T and A1298C and PAI-1 4G/5G are well-established risk factors for thrombosis. We aimed to investigate the prevalence of these gene mutations and their possible impact on the development of pathogenesis in patients with Sheehan's syndrome (SS). 40 female patients with SS compared to a control group of 45 healthy women. The presence of FV-Leiden, FII G20210A, MTHFR C677T, MTHFR A1298C and PAI-1 4G/5G gene mutations were assessed by polymerase chain reaction analysis with a light cycler analyzer. An odds ratio of greater than one is considered to increase the risk of SS disease as found in Factor V Leiden, FII G20210A, MTHFR C677T, MTHFR A1298C and PAI-1 4G/5G polymorphism, as follows respectively: 1.13, 1.85, 6.00, 8.14 and 1.45. MTHFR C677T and MTHFR A1298C polymorphism were found significantly higher in SS patients than the control group (P<0.001), however FV-Leiden, FII G20210A and PAI-1 4G/5G polymorphism showed no significant difference (P>0.05). The level of plasma total homocysteine (tHcy) was significantly higher in patients with SS than in the control group (P<0.001). We suggest that the genetic mutations of FV-Leiden, FII G20210A, MTHFR C677T, MTHFR A1298C and PAI-1 4G/5G increase the risk of SS. Also, high plasma tHcy levels may be a risk factor for the development of SS.

show abstract

Hyperhomocysteinemia and venous thromboembolism: a risk factor more prevalent in the elderly and in idiopathic cases

Cited by 34 publications

References 13 publications

A pilot study utilizing whole body 18 F-FDG-PET/CT as a comprehensive screening strategy for occult malignancy in patients with unprovoked venous thromboembolism

A pilot study utilizing whole body 18 F-FDG-PET/CT as a comprehensive screening strategy for occult malignancy in patients with unprovoked venous thromboembolism

Freqüência da mutação 844ins68 do gene da cistationina beta-sintetase em pacientes com trombose venosa profunda

Analysis of thrombophilic genetic mutations in patients with Sheehan`s syndrome: is thrombophilia responsible for the pathogenesis of Sheehan`s syndrome?

Contact Info

Product

Resources

About