Document Detail


Interrelation of hyperhomocyst(e)inemia, factor V Leiden, and risk of future venous thromboembolism.
MedLine Citation:
PMID:  9107163     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Because patients with rare familial homocystinuria who also carry factor V Leiden have an increased incidence of venous thromboembolism (VTE), we hypothesized an interrelation of moderate hyperhomocyst(e)inemia, factor V Leiden, and risk of VTE in the general population. METHODS AND RESULTS: In a large prospective cohort, we determined total homocysteine level and factor V Leiden mutation in baseline blood samples from 145 initially healthy men who subsequently developed VTE and among 646 men who remained free of vascular disease during a 10-year follow-up period. Hyperhomocyst(e)inemia was defined as a total homocysteine level above the 95th percentile (17.25 mumol/L). Compared with men with normal total homocysteine levels, those with hyperhomocyst(e)inemia had no increase in risk of any VTE but were at increased risk of idiopathic VTE (relative risk [RR] = 3.4, P = .002). Compared with men without Leiden mutation, those with mutation were at increased risk of developing any VTE (RR = 2.3, P = .005) as well as idiopathic VTE (RR = 3.6, P = .0002). Compared with men with neither abnormality, those affected by both disorders had a 10-fold increase in risk of any VTE (RR = 9.65, P = .009) and a 20-fold increase in risk of idiopathic VTE (RR = 21.8, P = .0004). CONCLUSIONS: Apparently healthy men with coexistent hyperhomocyst(e)inemia and Leiden mutation are at substantially increased risk of developing future VTEs, particularly those events considered idiopathic. In these data, the risk of VTE among doubly affected individuals was far greater than the sum of the individual risks associated with either abnormality alone.
Authors:
P M Ridker; C H Hennekens; J Selhub; J P Miletich; M R Malinow; M J Stampfer
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Circulation     Volume:  95     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:  1997 Apr 
Date Detail:
Created Date:  1997-05-13     Completed Date:  1997-05-13     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1777-82     Citation Subset:  AIM; IM    
Affiliation:
Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA. PMRIDKER@BICS.BWH.HARVARD.EDU
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MeSH Terms
Descriptor/Qualifier:
Aged
Alcohol Drinking / epidemiology
Blood Pressure
Boston / epidemiology
Case-Control Studies
Comorbidity
Diabetes Mellitus / epidemiology
Factor V / analysis*,  genetics
Female
Follow-Up Studies
Homocysteine / blood*
Humans
Male
Middle Aged
Prospective Studies
Pulmonary Embolism / epidemiology
Risk Factors
Smoking / epidemiology
Thromboembolism / blood,  epidemiology*,  etiology
Thrombophlebitis / epidemiology
Chemical
Reg. No./Substance:
0/factor V Leiden; 454-28-4/Homocysteine; 9001-24-5/Factor V
Comments/Corrections
Comment In:
Circulation. 1998 Jan 27;97(3):295-6   [PMID:  9462537 ]
Circulation. 1997 Apr 1;95(7):1749-51   [PMID:  9107156 ]
Circulation. 1998 Apr 14;97(14):1426-7   [PMID:  9577958 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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