Venous thromboembolism during pregnancy is not associated with persistent elevated activated protein C (APC) sensitivity ratio based on the endogenous thrombin potential
article
Women who are using oral contraceptives can acquire APC resistance, measured by the effect of APC on the endogenous thrombin potential (ETP). The objective of our study was to examine whether persistentAPC resistance determined with an ETP-based normalized APC sensitivity ratio (nAPCsr) is a risk marker for venous thromboembolism in women with pregnancy-associated thromboembolism. We determined the activities of antithrombin, protein C, protein S, and performed a genetic analysis of factor V Leiden G1691A, prothrombin mutation G20210A, and methylenetetrahydrofolate reductase mutation (MTHFR C677T) in 65 women with venous thromboembolism during pregnancy or the puerperium and in 114 normal women. A significantly (p<0.05) higher nAPCsr was present in normal women using hormones, in younger women (≤ 45 yrs), and in women with carrier status of factor V Leiden. In normal women without factor V Leiden a significant (p<0.05) negative correlation of nAPCsr with age (r=-0.39), antithrombin activity (r=-0.38), protein S activity (r=-0,26), and a significant positive correlation with hormone intake (r=0.36) was present. nAPCsr is influenced by several coagulation parameters, which are modified by the use of oral contraceptives. Consequently, a multivariate analysis of our data did not show a significant association of nAPCsr to venous thromboembolism, neither as a continuous variable (odds ratio 0.8,95% CI 0.6-1.1, p=0.10) nor using a cutoff value (nAPCsr cut-off 3.1: odds ratio 1.2, 95% CI 0.3-5.3, p=0.77). Our study demonstrates that nAPCsr is not a risk marker for pregnancy-associated venous thromboembolism. © 2005 Schattauer GmbH, Stuttgart. Chemicals / CAS: methylenetetrahydrofolate reductase (NADPH2), 71822-25-8; Protein C; Thrombin, EC 3.4.21.5
Topics
Biomedical ResearchAPC sensitivity ratio (nAPCsr)Endogenous thrombin potential (ETP)PregnancyVenous thromboembolismactivated protein Cblood clotting factor 5 Leidenmethylenetetrahydrofolate reductase (NADPH2)oral contraceptive agentactivated protein C resistanceadultarticlecontrolled studydisease associationdisease predispositionfemalegene mutationgenetic analysisgenetic riskgenetic susceptibilityhumanmajor clinical studymultivariate analysispregnancypriority journalpuerperiumrisk assessmentsensitivity analysisstatistical significancevenous thromboembolismActivated Protein C ResistanceAdultFemaleHumansMultivariate AnalysisPregnancyPregnancy Complications, CardiovascularPregnancy Complications, HematologicProtein CRisk FactorsThrombinThromboembolismThrombophiliaVenous Thrombosis
TNO Identifier
238336
ISSN
03406245
Source
Thrombosis and Haemostasis, 93(2), pp. 306-310.
Pages
306-310
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