title: Activated protein C resistance, factor V Leiden and peripheral vascular disease.
abstract: 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).
authors.affiliation: Department of Vascular Surgery, Bristol Royal Infirmary, UK.
authors.forename: P W
authors.initials: PW
authors.lastname: Foley
authors.forename: C D
authors.initials: CD
authors.lastname: Irvine
authors.forename: G R
authors.initials: GR
authors.lastname: Standen
authors.forename: C
authors.initials: C
authors.lastname: Morse
authors.forename: F T
authors.initials: FT
authors.lastname: Smith
authors.forename: C
authors.initials: C
authors.lastname: McGrath
authors.forename: R N
authors.initials: RN
authors.lastname: Baird
authors.forename: P M
authors.initials: PM
authors.lastname: Lamont
mesh_terms: 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
chemical_list: D011486:Protein C; C095381:factor V Leiden; D014859:Warfarin; D005165:Factor V