title: Arterial wall thickness and the risk of recurrent ischemic events in carriers of the prothrombin G20210A mutation with clinical manifestations of atherosclerosis.
abstract: The G20210A mutation in the prothrombin gene is an established risk factor for venous thrombosis. There is controversy about the role of this mutation in arterial thrombotic disease and atherosclerosis. We determined the presence of the prothrombin mutation and examined its influence on carotid and femoral artery intima-media thickness (IMT) and the occurrence of new ischemic events during follow-up in 277 patients with clinically manifest atherosclerotic disease: ischemic stroke, myocardial infarction or peripheral arterial disease. The mean age at entry was 63 years. Mean IMT was significantly higher in carriers of the prothrombin mutation (1.17 (SD 0.29) mm versus 0.97 (SD 0.25) mm: (delta)IMT=0.20, P=0.02). The increase in IMT was not attributable to differences in age, type of arterial disease or cardiovascular risk factors between carriers and non-carriers. During a mean follow-up of 3.5 years, a strong trend for more ischemic events was observed: 4 of the 11 carriers suffered from a recurrent ischemic event, compared with 30 of the 164 male non-carriers (36 versus 18%; P=0.06). These results suggest that the G20210A mutation contributes to the process of arterial wall thickening and is associated with the occurrence of ischemic events in a cohort of elderly persons with established atherosclerosis.
authors.affiliation: Department of Internal Medicine, Slotervaartziekenhuis, Louwesweg 6, 1066 EC, Amsterdam, Netherlands. igvge@slz.nl
authors.forename: Victor E A
authors.initials: VE
authors.lastname: Gerdes
authors.forename: Hugo
authors.initials: H
authors.lastname: ten Cate
authors.forename: Eric
authors.initials: E
authors.lastname: de Groot
authors.forename: Vincent I H
authors.initials: VI
authors.lastname: Kwa
authors.forename: Martin H
authors.initials: MH
authors.lastname: Prins
authors.forename: Pieter H
authors.initials: PH
authors.lastname: Reitsma
authors.forename: Harry R
authors.initials: HR
authors.lastname: Büller
authors.forename: Dees P M
authors.initials: DP
authors.lastname: Brandjes
mesh_terms: D000368:Aged; D001161:Arteriosclerosis / Q000000981:diagnostic imaging / Q000235:genetics* / Q000473:pathology; D002339:Carotid Arteries; D015331:Cohort Studies; D005260:Female; D005263:Femoral Artery; D005819:Genetic Markers; D006579:Heterozygote; D006801:Humans; D008297:Male; D008875:Middle Aged; D009154:Mutation; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging / Q000235:genetics* / Q000473:pathology; D011336:Probability; D011446:Prospective Studies; D011516:Prothrombin / Q000032:analysis / Q000235:genetics*; D012008:Recurrence; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D017539:Tunica Intima / Q000473:pathology*; D017540:Tunica Media / Q000473:pathology*; D014463:Ultrasonography
chemical_list: D005819:Genetic Markers; D011516:Prothrombin