Virginie Siguret1, Joseph Emmerich2, Tiphaine Belleville3, Jean-Louis Golmard4, Elisabeth Mazoyer5, Isabelle Gouin-Thibault6, Eric Pautas7. 1. UniversitéParis Descartes, Sorbonne Paris Cité, INSERM UMR-S-1140, France. Assistance Publique Hôpitaux de Paris, Service d'Hématologie biologique, Hôpital Européen Georges Pompidou, France. virginie.siguret@parisdescartes.fr. 2. UniversitéParis Descartes, Sorbonne Paris Cité, INSERM UMR-S-1140, France. Assistance Publique Hôpitaux de Paris, Service de Médecine vasculaire-HTA, Hôpital Européen Georges Pompidou, France. 3. UniversitéParis Descartes, Sorbonne Paris Cité, INSERM UMR-S-1140, France. 4. Assistance Publique Hôpitaux de Paris, Département de Biostatistiques, GH Pitié-Salpêtrière-Charles Foix, France. 5. Assistance Publique Hôpitaux de Paris, Service d'Hématologie biologique, Hôpital Cochin, France. 6. UniversitéParis Descartes, Sorbonne Paris Cité, INSERM UMR-S-1140, France. Assistance Publique Hôpitaux de Paris, Service d'Hématologie biologique, Hôpital Cochin, France. 7. UniversitéParis Descartes, Sorbonne Paris Cité, INSERM UMR-S-1140, France. Assistance Publique Hôpitaux de Paris, Court séjour gériatrique, DHU FAST, GH Pitié-Salpêtrière-Charles Foix, Ivry sur Seine, France. UniversitéPierre et Marie Curie, Facultéde Médecine, Paris, France.
Abstract
BACKGROUND: Few studies focused on genetic risk factors for venous thromboembolism (VTE) in the very elderly people. In patients aged 75 years and older with VTE referred for laboratory screening tests for thrombophilia, we aimed: (i) to estimate the F5G1691A and F2G20210A mutation prevalence; (ii) to compare prevalence rates with those of a control group; and (iii) to compare the prevalence rates between patient subgroups, defined as with one or multiple VTE episodes and with provoked/unprovoked VTE. METHODS: Data were extracted from two prospective thrombophilia registries according to the following inclusion criteria: Caucasian patients aged 75 years and older presenting with at least one confirmed VTE episode. Associated VTE risk factors had been recorded using a standardized questionnaire. Laboratory tests included plasma antithrombin, protein C, and protein S activity measurements and F5G1691A and F2G20210A genotyping. RESULTS: Of the 312 patients (mean age: 84 ± 6 years; 245 women and 67 men), 47.1% had two or more VTE episodes and 63.5% patients had unprovoked VTE. None had deficiencies in antithrombin, protein C, or protein S. The F5G1691A and F2G20210A mutations were found in 29 (9.3%, 95% confidence interval [CI]: 6.3-13.1) and 18 (5.8%, 95% CI: 3.5-9.0) patients, respectively, versus 3.4% (95% CI: 1.9-4.9) and 3.1% (95% CI: 2.6-3.5) in control subjects (p = .0002 and p = .0082, respectively). Overall, 45 (14.4%) patients carried at least one mutated allele. No associations were found between F5G1691A/F2G20210A, unprovoked VTE or recurrence (p > .05). CONCLUSIONS: Our study provides new data on genetic risk factors for VTE in the very elderly people. Whether identification of hereditary thrombophilia in elderly patients may influence patient's management in this age group remains unanswered.
BACKGROUND: Few studies focused on genetic risk factors for venous thromboembolism (VTE) in the very elderly people. In patients aged 75 years and older with VTE referred for laboratory screening tests for thrombophilia, we aimed: (i) to estimate the F5G1691A and F2G20210A mutation prevalence; (ii) to compare prevalence rates with those of a control group; and (iii) to compare the prevalence rates between patient subgroups, defined as with one or multiple VTE episodes and with provoked/unprovoked VTE. METHODS: Data were extracted from two prospective thrombophilia registries according to the following inclusion criteria: Caucasian patients aged 75 years and older presenting with at least one confirmed VTE episode. Associated VTE risk factors had been recorded using a standardized questionnaire. Laboratory tests included plasma antithrombin, protein C, and protein S activity measurements and F5G1691A and F2G20210A genotyping. RESULTS: Of the 312 patients (mean age: 84 ± 6 years; 245 women and 67 men), 47.1% had two or more VTE episodes and 63.5% patients had unprovoked VTE. None had deficiencies in antithrombin, protein C, or protein S. The F5G1691A and F2G20210A mutations were found in 29 (9.3%, 95% confidence interval [CI]: 6.3-13.1) and 18 (5.8%, 95% CI: 3.5-9.0) patients, respectively, versus 3.4% (95% CI: 1.9-4.9) and 3.1% (95% CI: 2.6-3.5) in control subjects (p = .0002 and p = .0082, respectively). Overall, 45 (14.4%) patients carried at least one mutated allele. No associations were found between F5G1691A/F2G20210A, unprovoked VTE or recurrence (p > .05). CONCLUSIONS: Our study provides new data on genetic risk factors for VTE in the very elderly people. Whether identification of hereditary thrombophilia in elderly patients may influence patient's management in this age group remains unanswered.