Activated protein C resistance, factor V Leiden and peripheral vascular disease.
Activated protein C resistance caused by factor V Leiden is an important thrombophilia disorder which predisposes to venous thromboembolism. Some studies also suggest a role in the pathogenesis of arterial thrombosis and atherosclerosis. The authors have investigated the prevalence of activated protein C resistance and factor V Leiden in a series of 45 patients with peripheral vascular disease. Twelve patients were receiving warfarin. The activated protein C resistance ratios were significantly lower in the group of 33 non-warfarinized patients with peripheral vascular disease (median 2.82 (range 1.36-3.83)) compared with 33 age- and sex-matched controls (median 2.97 range 2.24-4.11); P<0.005; Wilcoxon rank sum). Eight patients (24%) had activated protein C resistance (ratio <2.2). The prevalence of factor V Leiden in patients with peripheral vascular disease was 17.8% (8/45). This is significantly increased compared with the local population and UK published frequency of 3.5% for this genotype. The presence of factor V Leiden did not affect the late outcome of arterial reconstructive surgery in terms of graft patency (P=0.5, Fisher's Exact test).
Foley
P W
PW
Department of Vascular Surgery, Bristol Royal Infirmary, UK.
Irvine
C D
CD
Standen
G R
GR
Morse
C
C
Smith
F T
FT
McGrath
C
C
Baird
R N
RN
Lamont
P M
PM
D000368:Aged; D001161:Arteriosclerosis / Q000097:blood* / Q000601:surgery; D001780:Blood Coagulation Tests; D004789:Enzyme Activation / Q000187:drug effects / Q000502:physiology; D005165:Factor V / Q000378:metabolism*; D005260:Female; D006083:Graft Occlusion, Vascular / Q000097:blood* / Q000601:surgery; D006801:Humans; D007511:Ischemia / Q000097:blood* / Q000601:surgery; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D011486:Protein C / Q000378:metabolism*; D012086:Reoperation; D012307:Risk Factors; D014859:Warfarin / Q000008:administration & dosage
D011486:Protein C; C095381:factor V Leiden; D014859:Warfarin; D005165:Factor V