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Apparent different thrombotic tendency in patients with factor V Leiden and
protein C deficiency due to selection of patients
RP Lensen, FR Rosendaal, T Koster, CF Allaart, H de Ronde, JP Vandenbroucke, PH Reitsma and RM Bertina
Department of Clinical Epidemiology, University Hospital Leiden, The
Netherlands.
Both activated protein C (APC) resistance and protein C deficiency are
associated with an increased risk for venous thrombosis. To assess their
tendencies to venous thrombosis, we compared the median age of first venous
thromboembolism in patients with factor V Leiden or protein C deficiency,
who were identified either within unselected consecutive cases with a first
deep venous thrombosis derived from a population-based case-control study,
or identified by selection of patients with a deep venous thrombosis, who
were referred for thrombophilIa work-up. The median age of onset for 92
unselected APC resistant cases was 43 years and for 13 unselected protein
C-deficient cases 47 years. The median age at the first thrombotic event
for 28 APC- resistant members of thrombophilia families was 29 years and
for 50 protein C-deficient members of thrombophilia families 31.5 years.
The median age of onset for all unselected patients (n = 105) was 45 years
of age (range, 16 to 69 years) and the median age of onset for all selected
patients from the thrombophilia families (n = 78) was 30.5 years (range, 16
to 67 years). These results show that within the case- control study and
the family studies, the median age of onset is very similar in patients
with APC resistance and patients with protein C deficiency. This suggests
that APC resistance is not less severe with respect to risk of thrombosis
than (heterozygous) protein C deficiency. In conclusion, the median age at
which the first thrombosis occurs mainly depends on the way the patients
are identified and not on the type of thrombophilia.
Volume 88,
Issue 11,
pp. 4205-4208,
12/01/1996
Copyright © 1996 by The American Society of Hematology
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