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Blood, 1 December 2008, Vol. 112, No. 12, pp. 4432-4436. Prepublished online as a Blood First Edition Paper on September 12, 2008; DOI 10.1182/blood-2008-06-163279. This Article Full Text Full Text (PDF) Supplemental Appendix All Versions of this Article: blood-2008-06-163279v1 112/12/4432    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Kearon, C. Articles by Ginsberg, J. S. Search for Related Content PubMed PubMed Citation Articles by Kearon, C. Articles by Ginsberg, J. S. Related Collections Hemostasis, Thrombosis, and Vascular Biology Neoplasia Free Research Articles Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL TRIALS AND OBSERVATIONS Influence of thrombophilia on risk of recurrent venous thromboembolism while on warfarin: results from a randomized trial Clive Kearon1,2, Jim A. Julian1,2, Michael J. Kovacs3, David R. Anderson4, Philip Wells5, Betsy MacKinnon1,2, Jeffrey I. Weitz1,2, Mark A. Crowther1, Sean Dolan6, Alexander G. Turpie1, William Geerts7, Susan Solymoss8, Paul van Nguyen9, Christine Demers10, Susan R. Kahn8, Jeannine Kassis9, Marc Rodger5, Julie Hambleton11, Michael Gent1,2, Jeffrey S. Ginsberg1,2, for the ELATE Investigators 1 McMaster University, Hamilton, ON; 2 Henderson Research Centre, Hamilton, ON; 3 University of Western Ontario, London, ON; 4 Dalhousie University, Halifax, NS; 5 Clinical Epidemiology Program, Ottawa Health Research Institute, The Ottawa Hospital, University of Ottawa, Ottawa, ON; 6 University of New Brunswick, St John, NB; 7 University of Toronto, Toronto, ON; 8 McGill University, Montreal, QC; 9 University of Montreal, Montreal, QC; 10 Laval University, Quebec City, QC; and 11 University of California, San Francisco We sought to determine whether thrombophilic defects increase recurrent venous thromboembolism (VTE) during warfarin therapy. Six hundred sixty-one patients with unprovoked VTE who were randomized to extended low-intensity (international normalized ratio [INR], 1.5-1.9) or conventional-intensity (INR, 2.0-3.0) anticoagulant therapy were tested for thrombophilia and followed for a mean of 2.3 years. One or more thrombophilic defects were present in 42% of patients. The overall rate of recurrent VTE was 0.9% per patient-year. Recurrent VTE was not increased in the presence of factor V Leiden (hazard ratio [HR], 0.7; 95% CI, 0.2-2.6); the 20210G>A prothrombin gene mutation (HR, 0); antithrombin deficiency (HR, 0); elevated factor VIII (HR, 0.7; 95% CI, 0.1-5.4); elevated factor XI (HR, 0.7; 95% CI, 0.1-5.0), or elevated homocysteine (HR, 0.7; 95% CI, 0.1-5.3), but showed a trend to an increase with an antiphospholipid antibody (HR, 2.9; 95% CI, 0.8-10.5). Compared with patients with no thrombophilic defects, the rate of recurrence was not increased in the presence of one (HR, 0.7; 95% CI, 0.2-2.3) or more than one (HR, 0.7; 95% CI, 0.2-3.4) defect. We conclude that single or multiple thrombophilic defects are not associated with a higher risk of recurrent VTE during warfarin therapy. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: J. B. Segal, D. J. Brotman, A. J. Necochea, A. Emadi, L. Samal, L. M. Wilson, M. T. Crim, and E. B. Bass Predictive Value of Factor V Leiden and Prothrombin G20210A in Adults With Venous Thromboembolism and in Family Members of Those With a Mutation: A Systematic Review JAMA, June 17, 2009; 301(23): 2472 - 2485. [Abstract] [Full Text] [PDF] W. M. Lijfering, J.-L. P. Brouwer, N. J. G. M. Veeger, I. Bank, M. Coppens, S. Middeldorp, K. Hamulyak, M. H. Prins, H. R. Buller, and J. van der Meer Selective testing for thrombophilia in patients with first venous thrombosis: results from a retrospective family cohort study on absolute thrombotic risk for currently known thrombophilic defects in 2479 relatives Blood, May 21, 2009; 113(21): 5314 - 5322. [Abstract] [Full Text] [PDF] T. Zhu, I. Martinez, and J. Emmerich Venous Thromboembolism: Risk Factors for Recurrence Arterioscler. Thromb. Vasc. Biol., March 1, 2009; 29(3): 298 - 310. [Abstract] [Full Text] [PDF]

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