Lamin A/C mutation is independently associated with an increased risk of arterial and venous thromboembolic complications.
BACKGROUND
Lamin A/C (LMNA) mutation carriers suffer from a variety of clinical phenotypes, including dilated cardiomyopathy (DCM). Although it has been suggested that carriers are at risk for thromboembolic complications, it is unknown whether this risk is higher than can be expected from the underlying cardiac abnormalities. The purpose of this study was to determine whether a LMNA mutation is associated with an increased risk of thromboembolic complications.


METHODS
We compared a cohort of 76 LMNA mutation carriers with a cohort of 224 idiopathic DCM patients without a LMNA mutation, with respect to the prevalence of arterial and venous thromboembolic complications. Furthermore, we carried out a case-control study to explore whether a prothrombotic phenotype was present in LMNA mutation carriers without DCM or atrial tachyarrhythmias (n=14) and compared this with mutation negative relatives (n=13).


RESULTS
The prevalence of thromboembolic complications was higher in the cohort of LMNA mutation carriers than in DCM patients (22 vs 11%; p<0.05), after respectively mean follow-up of 42 ± 12 and 49 ± 12 years. After adjustment for possible confounders, including atrial tachyarrhythmias and left ventricular ejection fraction, LMNA mutation carriership was independently associated with an increased risk of thromboembolic complications (HR 4.8, 95% CI: 2.2-10.6). The results of the case-control study suggested a prothrombotic phenotype in LMNA mutation carriers, as reflected by an altered platelet function and increased thrombin generation.


CONCLUSIONS
LMNA mutation is independently associated with an increased risk of arterial and venous thromboembolic complications. Laboratory research in LMNA mutation carriers without severe cardiac abnormalities suggests a prothrombotic phenotype.
ICIN Netherlands Heart Institute/Durrer Center for Cardiogenetic Research, The Netherlands.
Ingrid A W
IA
van Rijsingen
Annemieke
A
Bakker
Donija
D
Azim
Johanna F
JF
Hermans-van Ast
Anneke J
AJ
van der Kooi
J Peter
JP
van Tintelen
Maarten P
MP
van den Berg
Imke
I
Christiaans
Ronald H
RH
Lekanne Dit Deprez
Arthur A M
AA
Wilde
Aeilko H
AH
Zwinderman
Joost C M
JC
Meijers
Anita E
AE
Grootemaat
Rienk
R
Nieuwland
Yigal M
YM
Pinto
Sara-Joan
SJ
Pinto-Sietsma
D000328:Adult; D002311:Cardiomyopathy, Dilated / Q000175:diagnosis* / Q000235:genetics*; D016022:Case-Control Studies; D015331:Cohort Studies; D003331:Coronary Vessels / Q000473:pathology; D005260:Female; D006801:Humans; D034904:Lamin Type A / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D009154:Mutation / Q000235:genetics*; D012189:Retrospective Studies; D012307:Risk Factors; D054556:Venous Thromboembolism / Q000175:diagnosis* / Q000235:genetics*; D055815:Young Adult
D034904:Lamin Type A