Coagulation factors II, V, VII, and X, prothrombin gene 20210G-->A transition, and factor V Leiden in coronary artery disease: high factor V clotting activity is an independent risk factor for myocardial infarction.
Increased levels of hemostatic factors and genetic mutations of proteins involved in coagulation may play a role in the pathogenesis of coronary artery disease. We investigated clotting activity of factors II (FII:C), V (FV:C), VII (FVII:C), and X (FX:C), the prothrombin gene 20210G-->A transition, and the factor V Leiden mutation in 200 survivors of myocardial infarction and in 100 healthy controls. FV:C (P<0.0001) and FVII:C (P<0.0001) were found to be independent risk factors for myocardial infarction. High FV:C or high FVII:C combined with smoking or arterial hypertension increased the relative risk for myocardial infarction up to 50-fold. One of 177 patients (0.6%) and 4 of 89 controls (4.5%) had the prothrombin 20210 AG genotype. Eleven of 177 patients (6.2%) and 6 of 89 controls (6.7%) were heterozygous for the factor V Leiden mutation. No homozygous carrier for these mutations was found. Neither the prothrombin gene 20210G-->A transition (odds ratio [OR], 0.1; 95% confidence interval [CI], 0.01 to 1.1) nor the factor V Leiden mutation (OR, 1.0; 95% CI, 0.4 to 2.8) were associated with an increased relative risk for myocardial infarction. In conclusion, our data indicate that neither the prothrombin gene 20210G-->A transition nor the factor V Leiden mutation are risk factors for myocardial infarction. High FVII:C was confirmed to be an independent risk factor for myocardial infarction. Moreover, we describe for the first time that high FV:C is an independent risk factor for myocardial infarction.
Redondo
M
M
Central Hematology Laboratory, Inselspital, University Hospital Bern, Switzerland.
Watzke
H H
HH
Stucki
B
B
Sulzer
I
I
Biasiutti
F D
FD
Binder
B R
BR
Furlan
M
M
Lämmle
B
B
Wuillemin
W A
WA
D020016:Activated Protein C Resistance / Q000097:blood / Q000235:genetics; D000225:Adenine; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D003327:Coronary Disease / Q000097:blood* / Q000453:epidemiology; D005165:Factor V / Q000378:metabolism*; D005167:Factor VII / Q000378:metabolism; D005170:Factor X / Q000378:metabolism; D005260:Female; D006147:Guanine; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology*; D017354:Point Mutation; D011516:Prothrombin / Q000235:genetics* / Q000378:metabolism; D012307:Risk Factors; D013557:Switzerland / Q000453:epidemiology
C095381:factor V Leiden; D006147:Guanine; D005165:Factor V; D005167:Factor VII; D011516:Prothrombin; D005170:Factor X; D000225:Adenine