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Factor V Leiden (resistance to activated protein C) increases the risk of
myocardial infarction in young women
FR Rosendaal, DS Siscovick, SM Schwartz, RK Beverly, BM Psaty, WT Longstreth , TE Raghunathan, TD Koepsell and PH Reitsma
Department of Epidemiology, University of Washington, Seattle, USA.
Factor V Leiden (factor V Arg506Gln), the genetic defect underlying
resistance to activated protein C, is the most common risk factor for
venous thrombosis. The relationship between this genetic abnormality and
arterial disease is still unresolved. To assess whether factor V Leiden
increases the risk of myocardial infarction (MI), we conducted a
population-based case-control study among women 18 to 44 years of age in
western Washington state. We included 84 women with first MI and 388
control women, ie, women residing in the same area in the same age range
without MI (n = 388). The control women were contacted by random digit
dialing. Data on risk factor status were collected via personal interview,
and data on the factor V genotype via polymerase chain reaction techniques.
The factor V Leiden mutation was found more often in women with MI (10%)
than among controls (4%). The odds ratio for MI was 2.4 [95% confidence
interval (CI) 1.0 to 5.9]. The risk was increased fourfold (CIgs 1.2 to
12.1) when adjusted for major cardiovascular risk factors. Among nonsmokers
the factor V Leiden mutation had little effect (odds ratio 1.1, CI95 0.1 to
8.5), whereas it had a large effect among smokers (odds ratio 3.6, CI95 0.9
to 14.4), which, because smoking was itself a strong risk factor for MI,
led to an odds ratio for smoking carriers of the mutation that was 32-fold
increased compared with nonsmoking noncarriers. We conclude that factor V
Leiden increases the risk of MI in young women. This effect seems to be
confined largely to current smokers.
Volume 89,
Issue 8,
pp. 2817-2821,
04/15/1997
Copyright © 1997 by The American Society of Hematology
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C. D. Irvine, P. W.X. Foley, G. R. Standen, and C. Morse
Should Patients With Atherosclerosis or Peripheral Vascular Disease Be Stratified for Factor V Leiden?
Blood,
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P. C. Y. Liaw, T. Mather, N. Oganesyan, G. L. Ferrell, and C. T. Esmon
Identification of the Protein C/Activated Protein C Binding Sites on the Endothelial Cell Protein C Receptor. IMPLICATIONS FOR A NOVEL MODE OF LIGAND RECOGNITION BY A MAJOR HISTOCOMPATIBILITY COMPLEX CLASS 1-TYPE RECEPTOR
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