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Prepublished online as a Blood First Edition Paper on April 17, 2002; DOI 10.1182/blood-2002-01-0111.
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Blood, 1 July 2002, Vol. 100, No. 1, pp. 3-10
PLENARY PAPER
Factor V Leiden: The Copenhagen City Heart Study and 2 meta-analyses
Klaus Juul,
Anne Tybjærg-Hansen,
Rolf Steffensen,
Steen Kofoed,
Gorm Jensen, and
Børge Grønne Nordestgaard
From the Department of Clinical Biochemistry, Herlev
University Hospital, Herlev, Denmark; Department of Clinical
Biochemistry, Rigshospitalet, Copenhagen University Hospital,
Copenhagen, Denmark; Department of Medicine B, Hillerød Hospital,
Hillerød, Denmark; Department of Vascular Surgery, Gentofte University
Hospital, Gentofte, Denmark and the Copenhagen City Heart Study,
Bispebjerg University Hospital, University of Copenhagen, Copenhagen,
Denmark.
Factor V Leiden (FVL) is associated with venous thrombosis;
however, an association between FVL and arterial thrombosis remains controversial. We investigated FVL as a risk factor for myocardial infarction (MI), ischemic stroke (IS), or non-MI ischemic heart disease
(non-MI-IHD). The design was 3 case-control studies and 3 prospective
studies with 21 years' follow-up. The setting was the general
population in Copenhagen, Denmark. The participants for The Copenhagen
City Heart Study were 20- to 95-year-old participants without
cardiovascular disease (control population, n = 7907) or participants
diagnosed with MI (n = 469), IS (n = 231), or non-MI-IHD
(n = 365). In addition, 3 independent patient populations from Copenhagen University Hospital with MI (n = 493), IS
(n = 231), or non-MI-IHD (n = 448) were included. We measured FVL
genotype; major cardiovascular risk factors; and MI, IS, and
non-MI-IHD incidence and prevalence. Prevalences of FVL heterozygotes
and homozygotes in control subjects from the general population were 7.7% and 0.2%. Odds ratios and relative risks of MI in FVL carriers (heterozygotes + homozygotes) versus noncarriers were 1.24 (95% confidence interval [CI], 0.91-1.69) and 0.83 (0.58-1.20) in
case-control and prospective studies, respectively. Corresponding risks
for IS were 0.92 (95% CI, 0.56-1.53) and 0.68 (0.45-1.04), and for non-MI-IHD 1.01 (95% CI, 0.71-1.44) and 0.97 (0.66-1.42). Findings from The Copenhagen City Heart Study suggest that FVL is not associated with MI, IS, or non-MI-IHD.
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