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Ann Intern Med. 1997 Apr 1;126(7):528-31.

Age-specific incidence rates of venous thromboembolism among heterozygous carriers of factor V Leiden mutation.

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  • 1Department of Medicine, Brigham and Womens' Hospital, Harvard Medical School, Boston, MA 02115, USA.

Abstract

BACKGROUND:

Previous reports suggest that younger carriers of the factor V Leiden mutation are at greater risk for venous thromboembolism than are older carriers. However, available data on thromboembolic risk are limited.

OBJECTIVE:

To determine age-specific incidence rates of venous thromboembolism associated with the factor V Leiden mutation.

DESIGN:

Prospective cohort study.

PATIENTS:

14,916 initially healthy men participating in the Physicians' Health Study who were followed from 1982 to August 1994 for the occurrence of deep venous thrombosis or pulmonary embolism.

MEASUREMENTS:

Polymerase chain reaction was used to determine factor V Leiden mutation status in 156 study participants who developed venous thromboembolism during follow-up and in 2406 study participants who remained free of vascular disease.

RESULTS:

Risks for venous thromboembolism in heterozygous carriers of factor V Leiden mutation increased with age at a rate significantly greater than that in noncarriers. Whereas incidence rates of venous thromboembolism were similar in men with and men without the factor V Leiden mutation who were younger than 50 years of age, incidence rate differences (per 1000 person-years of observation) between affected and unaffected men increased significantly from 1.23 (95% CI, -0.4 to 2.9) for those aged 50 to 59 years to 1.61 (CI, -0.5 to 3.7) for those aged 60 to 69 years of age to 5.97 (CI, 0.6 to 11.3) for those aged 70 years or older (P for trend = 0.008). For idiopathic venous thromboembolism, age-specific incidence rate differences between men with and without the factor V Leiden mutation increased significantly with age (P = 0.017). However, no significant relation was found for secondary events (P > 0.2).

CONCLUSIONS:

The findings support the hypothesis that the pathogenesis of venous thromboembolism involves acquired as well as genetic risk factors and indicate that determination of factor V Leiden mutation status should not be limited to young patients.

PMID:
9092318
[PubMed - indexed for MEDLINE]
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