Prediction of recurrent venous thromboembolism by measuring ProC Global.
In patients with venous thromboembolism (VTE) a laboratory assay that globally measures the overall thrombophilic tendency is not available. We hypothesized that determination of ProC((R)) Global, a plasma assay which tests the global function of the protein C pathway, could be used to stratify patients according to their risk of recurrent VTE. We prospectively followed 774 patients with first spontaneousVTE for a mean time of 52 months. ProC Global normalized ratio (NR) was measured in plasma by use of a commercially available assay based on activated partial thromboplastin time. Ninety-eight of the 774 patients had recurrentVTE. Patients with ProC Global NR > or = 0.75 had a relative risk of recurrence of 0.59 (95% CI 0.40-0.87) as compared with those with lower ratio. After four years, cumulative probability of recurrence was 8.6% in patients with ProC Global NR > or = 0.75 and 17.4% in patients with a lower ratio (p = 0.006). Patients with a high ProC Global NR have a low risk of recurrent VTE. ProC Global NR can be used to stratify patients with a first unprovoked VTE according to their risk of recurrence.
Dept. of Internal Medicine I, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria. sabine.eichinger@meduniwien.ac.at
Sabine
S
Eichinger
Gregor
G
Hron
Mirko
M
Hirschl
Christine
C
Bialonczyk
Erich
E
Minar
Marietta
M
Kollars
Paul A
PA
Kyrle
D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use; D001317:Austria; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010314:Partial Thromboplastin Time; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011486:Protein C / Q000378:metabolism*; D011933:Reagent Kits, Diagnostic; D012008:Recurrence; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D013997:Time Factors; D054556:Venous Thromboembolism / Q000097:blood / Q000175:diagnosis* / Q000209:etiology / Q000517:prevention & control
D000925:Anticoagulants; D011486:Protein C; D011933:Reagent Kits, Diagnostic