Elevated endogenous thrombin potential is associated with an increased risk of a first deep venous thrombosis but not with the risk of recurrence.
Measurement of the thrombin generating potential could provide a method for quantifying the composite effect of multiple risk factors. This study assessed the risk of a first as well as a recurrent venous thrombotic event associated with an increased endogenous thrombin potential (ETP). Analyses were performed in 360 patients and 404 control subjects of the Leiden Thrombophilia Study. The ETP was measured directly using a fluorogenic assay (Thrombinoscope). Individuals with an increased ETP, i.e. above 90th percentile measured in control subjects (>2109.0 nM x min) had a 1.5-fold [95% confidence interval (CI): 0.9-2.3] increased risk of a first deep venous thrombosis. The risk was more pronounced after the analysis was restricted to idiopathic thromboses, i.e. 1.7-fold (95% CI: 1.0-2.8). Overall, the hazard ratio of a recurrent thrombotic event associated with a high ETP, adjusted for age, sex and oral anticoagulant use was 1.1 (95% CI: 0.5-2.2). Thus, a high ETP was not associated with an increased relative risk of recurrent venous thrombosis. At present, the clinical relevance of the thrombin generation assay in predicting recurrent venous thrombosis remains uncertain.
van Hylckama Vlieg
A
A
Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.
Christiansen
S C
SC
Luddington
R
R
Cannegieter
S C
SC
Rosendaal
F R
FR
Baglin
T P
TP
D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use; D001780:Blood Coagulation Tests; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D016016:Proportional Hazards Models; D012008:Recurrence; D018570:Risk Assessment / Q000379:methods; D016019:Survival Analysis; D013917:Thrombin / Q000096:biosynthesis*; D020246:Venous Thrombosis / Q000097:blood* / Q000188:drug therapy
D000925:Anticoagulants; D013917:Thrombin