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Resistance to activated protein C in unselected patients with arterial and venous thrombosis.

Abstract
Four hundred and ninety-three consecutive patients referred for arterial or venous thrombosis were screened for congenital and acquired abnormalities of blood coagulation predisposing to thrombosis, and were compared to 341 age- and sex-matched controls. The aim of the study was to determine the prevalence and clinical characteristics of resistance to activated protein C (APC), a defect shown to have different prevalences in different ethnic groups and to be associated with an increased risk of thrombosis. Seventy-three (15%) patients had both APC resistance and the 1691 G to A factor V gene mutation, compared to 6/341 (2%) controls. Seven patients had antithrombin deficiency (1.4%), 11 had protein C deficiency (2.2%), and 4 had protein S deficiency (0.8%). The relative risk of thrombosis in APC-resistant patients was 9.4. Resistance to APC was associated mainly with venous thrombosis, the most frequent being deep-vein thrombosis of the lower limbs. Fifty-eight percent of APC-resistant patients had an associated risk factor at the first thrombotic event: pregnancy and oral contraceptive intake were associated with the first thrombotic episode in 35% and 30% of women, respectively. APC resistance is the most frequent defect of blood coagulation in the general population and in the unselected thrombotic population studied by us.
AuthorsE M Faioni, C Razzari, I Martinelli, D Panzeri, F Franchi, P M Mannucci
JournalAmerican journal of hematology (Am J Hematol) Vol. 55 Issue 2 Pg. 59-64 (Jun 1997) ISSN: 0361-8609 [Print] United States
PMID9208999 (Publication Type: Journal Article)
Chemical References
  • Contraceptives, Oral
  • Protein C
  • Factor V
Topics
  • Adult
  • Aged
  • Blood Coagulation Disorders (physiopathology)
  • Contraceptives, Oral (adverse effects)
  • Enzyme Activation
  • Factor V (genetics)
  • Female
  • Humans
  • Male
  • Middle Aged
  • Point Mutation
  • Pregnancy
  • Pregnancy Complications, Hematologic
  • Protein C (metabolism)
  • Protein C Deficiency
  • Protein S Deficiency (complications)
  • Risk Factors
  • Thrombosis (physiopathology)

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