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Randomized Controlled Trial
. 2009 Oct 1;114(14):2878-83.
doi: 10.1182/blood-2009-05-219915. Epub 2009 Jul 17.

Coagulation factors IX through XIII and the risk of future venous thrombosis: the Longitudinal Investigation of Thromboembolism Etiology

Mary Cushman  1 , Ellen S O'Meara, Aaron R Folsom, Susan R Heckbert
Affiliations
Randomized Controlled Trial

Coagulation factors IX through XIII and the risk of future venous thrombosis: the Longitudinal Investigation of Thromboembolism Etiology

Mary Cushman et al. Blood. .

Abstract

Higher levels of procoagulant factors and factor XII deficiency may be risk factors for first venous thromboembolism (VTE). We studied associations of coagulation factors IX through XIII with risk of future VTE in 2 general population samples. Using a nested case-control study combining the 21 860 participants of the Atherosclerosis Risk in Communities study and the Cardiovascular Health Study, we determined antigenic levels of these coagulation factors in primarily pre-event blood samples from 462 participants who subsequently developed VTE and 1047 participants who remained free of VTE. Only elevated levels of factors IX and XI were associated with increased risk of VTE after adjustment for age, sex, race, and study. For factor IX, the odds ratio (OR) was 1.4 (95% confidence interval [CI], 1.0-2.0) comparing the top to bottom quintile. The OR for factor XI was higher: 2.0 (95% CI, 1.4-2.9). With further adjustment for body mass index and diabetes, only elevated factor XI remained associated with VTE risk: OR 1.8 (95% CI, 1.3-2.7). Associations were similar by study and whether the thrombosis was idiopathic or secondary. Factor XII deficiency was not related to VTE risk. Among these procoagulant factors, only elevated factor XI was a risk factor for VTE.

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Figures

Figure 1
Figure 1
Odds ratios of venous thromboembolism by quintiles of coagulation factors. Analyses were adjusted for age, sex, race, and study. ♦ represents factor IX; ■, factor X; ▴, factor XI; □, factor XII; and ●, factor XIII. Fifth quintile cutoffs are 167% for factor IX, 161% for factor X, 157% for factor XI, 179% for factor XII, and 171% for factor XIII.
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