Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Mar;24(2):295-302.
doi: 10.1177/1076029617703481. Epub 2017 Apr 12.

Thrombophilia in 153 Patients With Premature Cardiovascular Disease ≤Age 45

Alexander Milgrom  1 , Kevin Lee  1 , Matan Rothschild  1 , Frini Makadia  1 , Greg Duhon  1 , Sarah Min  1 , Ping Wang  1 , Charles J Glueck  1
Affiliations

Thrombophilia in 153 Patients With Premature Cardiovascular Disease ≤Age 45

Alexander Milgrom et al. Clin Appl Thromb Hemost. 2018 Mar.

Abstract

We assessed contributions of thrombophilia to premature cardiovascular disease (CVD) events (≤ age 45) in 153 patients. Test results of thrombophilia-hypofibrinolysis were obtained in 153 patients with CVD ≤ age 45, 110 healthy normal controls, and 110 patients who had venous thromboembolism (VTE) without CVD. Of the 153 patients with CVD, 121 (79%) had sustained myocardial infarction, 70 (46%) had coronary artery stenting, and 53 (35%) had coronary artery bypass grafts. The first CVD events occurred at ages >20 to 35 in 47 patients and at ages >35 to 45 in 106 patients. At study entry, median low-density lipoprotein cholesterol was 126 mg/dL, 56 (37%) smoked, 56 (37%) had hypertension, and 56 (37%) were diabetic. Cases differed from normal controls for high factor VIII (10 [22%] of 45 vs 7 of 103 [7%], P = .007), high homocysteine (32 [21%] of 151 vs 5 [5%] of 107, P = .0002), low free protein S (5 [11%] of 44 vs 2 [2%] of 96, P = .032), high anticardiolipin antibodies (ACLA) IgM (11 [9%] of 129 vs 2 [2%] of 109, P = .024), high lipoprotein (a) [Lp(a)] (46 [30%] of 151 vs 21 [19%] of 110, P = .038), and the lupus anticoagulant (4 [11%] of 37 vs 2 [2%] of 110, P = .035). There were no differences ( P > .05) between cases and VTE controls except free protein S and Lp(a). Free protein S was more often low in VTE controls (24 [28%] of 85 vs 5 [11%] of 44, P = .03) and Lp(a) was more often high in cases (46 [30%] of 151, VTE controls 12 [17%] of 71, P = .032). In 153 patients with premature CVD ≤ age 45, thrombophilia was pervasive (high factor VIII, homocysteine, ACLA IgM, low free protein S, high Lp(a), and lupus anticoagulant), evidencing thrombotic contribution to premature CVD. Moreover, thrombophilia in patients with premature CVD was comparable to VTE controls, emphasizing the pervasive nature of thrombophilia in premature CVD.

Keywords: atherosclerosis; clinical thrombophilia; thrombophilia; vascular disease; venous thromboembolism.

PubMed Disclaimer

Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

References

    1. Andreotti F, Becker R. Atherothrombotic disorders: new insights from hematology. Circulation. 2005;111(14):1855–1863. - PubMed
    1. Rosendaal F, Siscovick D, Schwartz S, et al. Factor V Leiden (resistance to activated protein C) increases the risk of myocardial infarction in young women. Blood. 1997;89(8):2817–2821. - PubMed
    1. French J, Van de Water NS, Sutton T, et al. Potential thrombophilic mutations/polymorphisms in patients with no flow-limiting stenosis after myocardial infarction. Am Heart J. 2003;145(1):188–124. - PubMed
    1. Voetsch B, Loscalzo J. Genetic determinants of arterial thrombosis. Arterioscler Thromb Vasc Biol. 2004;24(2):216–229. - PubMed
    1. Kim R, Bedcker R. Association between factor V Leiden, prothrombin G20210A, and methylenetetrahydrofolate reductase C677 T mutations and events of the arterial circulatory system: a meta-analysis of published studies. Am Heart J. 2003;146(6):948–957. - PubMed

LinkOut - more resources