title: The influence of thrombophilia on the long-term survival of patients with a history of venous thromboembolism.
abstract: Data on the long-term survival following venous thromboembolism (VTE) are rare, and the influence of thrombophilia has not been evaluated thus far. Our aim was to assess thrombophilia-parameters as predictors for long-term survival of patients with VTE. Overall, 1,905 out-patients (99 with antithrombin-, protein C or protein S deficiency, 517 with factor V Leiden, 381 with elevated factor VIII and 160 with elevated homocysteine levels, of these 202 had a combination and 961 had none of these risk factors) were included in the study between September 1, 1994 and December 31, 2007. Retrospective survival analysis showed that a total of 78 patients (4.1%) had died during the analysis period, among those four of definite or possible pulmonary embolism and four of bleeding. In multivariable analysis including age and sex an association with increased mortality was found for hyperhomocysteinemia (hazard ratio 2.0 [1.1.-3.5]) whereas this was not the case for all other investigated parameters. We conclude that the classical hereditary thrombophilia risk factors did not have an impact on the long-term survival of patients with a history of VTE. Thus our study supports the current concept that thrombophilia should not be a determinant for decision on long term anticoagulation. However, hyperhomocysteinaemia, known as a risk factor for recurrent VTE and arterial disease, might impact survival.
authors.affiliation: Division of Haematology and Haemostaseology, Department of Medicine I, Medical University of Vienna, WaehringerGuertel 18-20, A-1090 Vienna, Austria.
authors.forename: Sylvia
authors.initials: S
authors.lastname: Reitter-Pfoertner
authors.forename: Thomas
authors.initials: T
authors.lastname: Waldhoer
authors.forename: Michaela
authors.initials: M
authors.lastname: Mayerhofer
authors.forename: Ernst
authors.initials: E
authors.lastname: Eigenbauer
authors.forename: Cihan
authors.initials: C
authors.lastname: Ay
authors.forename: Christine
authors.initials: C
authors.lastname: Mannhalter
authors.forename: Paul Alexander
authors.initials: PA
authors.lastname: Kyrle
authors.forename: Ingrid
authors.initials: I
authors.lastname: Pabinger
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000991:Antithrombins / Q000097:blood; D001317:Austria / Q000453:epidemiology; D015415:Biomarkers / Q000097:blood; D002423:Cause of Death; D005165:Factor V / Q000235:genetics; D005169:Factor VIII / Q000032:analysis; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D020138:Hyperhomocysteinemia / Q000097:blood / Q000401:mortality; D053208:Kaplan-Meier Estimate; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D016016:Proportional Hazards Models; D020151:Protein C Deficiency / Q000097:blood / Q000401:mortality; D018455:Protein S Deficiency / Q000097:blood / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D017741:Survivors / Q000706:statistics & numerical data*; D019851:Thrombophilia / Q000097:blood / Q000235:genetics / Q000401:mortality*; D013997:Time Factors; D054556:Venous Thromboembolism / Q000097:blood / Q000235:genetics / Q000401:mortality*; D055815:Young Adult
chemical_list: D000991:Antithrombins; D015415:Biomarkers; C095381:factor V Leiden; C078147:F8 protein, human; D005165:Factor V; D005169:Factor VIII