title: Absolute annual incidences of first events of venous thromboembolism and arterial vascular events in individuals with elevated FVIII:c. A prospective family cohort study.
abstract: Elevated levels of factor VIII:c (elevated FVIII:c) are associated with an increased risk for venous thromboembolism (VTE) and arterial vascular events, and are at least in part determined genetically. We prospectively followed 192 asymptomatic individuals with elevated FVIII:c (>150%) and 340 with normal levels for an average duration of 31 months (range 7 to 56 months) to investigate the risk of VTE and arterial vascular events. Participants were first degree relatives of consecutive patients with elevated FVIII:c and VTE or arterial vascular events before the age of 50 years. The incidences of VTE were 1.25% (0.46-2.73) per year in the subjects with elevated FVIII:c, versus 0.23% (0.03-0.82) in those with normal levels (OR 5.5 [1.1-27.3]). The annual incidences of arterial vascular events were 1.04% (0.34-2.42) and 0.23% (0.03-0.82) in relatives with and without elevated levels of FVIII:c, respectively (OR: 4.5 [0.9-23.5]). After adjustment for age, smoking, known diabetes mellitus, hyperlipidemia, and hypertension, the odds ratio for any event was 3.7 (1.1-13.1). In conclusion, asymptomatic individuals with elevated FVIII:c levels and a positive family history of VTE or arterial vascular events before the age of 50 appear to have a high annual incidence of first VTE and arterial vascular events. Elevated FVIII:c may be a common risk factor for both clinical entities.
authors.affiliation: Department of Vascular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. I.Bank@amc.uva.nl
authors.forename: Ivan
authors.initials: I
authors.lastname: Bank
authors.forename: Marlène H W
authors.initials: MH
authors.lastname: van de Poel
authors.forename: Michiel
authors.initials: M
authors.lastname: Coppens
authors.forename: Karly
authors.initials: K
authors.lastname: Hamulyák
authors.forename: Martin H
authors.initials: MH
authors.lastname: Prins
authors.forename: Jan
authors.initials: J
authors.lastname: van der Meer
authors.forename: Nic J G M
authors.initials: NJ
authors.lastname: Veeger
authors.forename: Harry R
authors.initials: HR
authors.lastname: Büller
authors.forename: Saskia
authors.initials: S
authors.lastname: Middeldorp
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D001157:Arterial Occlusive Diseases / Q000097:blood* / Q000453:epidemiology / Q000209:etiology*; D015331:Cohort Studies; D005169:Factor VIII / Q000032:analysis*; D005192:Family Health; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011446:Prospective Studies; D012307:Risk Factors; D054556:Venous Thromboembolism / Q000097:blood / Q000453:epidemiology / Q000209:etiology*
chemical_list: D005169:Factor VIII