International Journal of General Medicine (Nov 2023)
Clinical Investigation of Hereditary and Acquired Thrombophilic Factors in Patients with Venous and Arterial Thromboembolism
Abstract
Erzsebet Kovács,1 Zsuzsanna Bereczky,2 Adrienne Kerényi,3 Renáta Laczik,4 Valéria Nagy,5 Dávid Ágoston Kovács,6 Sándor Kovács,7 György Pfliegler1 1Centre of Rare Diseases, Department of Internal Medicine, University of Debrecen, Debrecen, Hungary; 2Division of Clinical Laboratory Science, Department of Laboratory Medicine, University of Debrecen, Debrecen, Hungary; 3Department of Laboratory Medicine, University of Debrecen, Debrecen, Hungary; 4Division of Angiology, Department of Internal Medicine, University of Debrecen, Debrecen, Hungary; 5Department of Ophthalmology, University of Debrecen, Debrecen, Hungary; 6Department of Surgery, University of Debrecen, Debrecen, Hungary; 7Department of Research Methodology and Statistics, Institute of Sectoral Economics and Methodology, University of Debrecen, Debrecen, HungaryCorrespondence: Erzsebet Kovács, Centre of Rare Diseases, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, 98 Nagyerdei krt, Debrecen, H-4032, Hungary, Tel +36 52 255574, Email [email protected]: The clinical relevance of thrombophilic laboratory factors, especially the “mild” ones, and the need for their screening is not generally recommended in venous (VTE) and/or arterial (ATE) thromboembolism.Methods: Our aim was to investigate possible associations between comorbidities and 16 inherited/acquired “severe” and “mild” laboratory thrombophilic factors (detailed in introduction) in patients (n=348) with VTE/ATE without a serious trigger (high-risk surgical intervention, active cancer and/or chemo-radiotherapy). Cases with VTE/ATE were enrolled when the thrombotic event occurred under the age of 40, in case of positive family history, recurrent thromboembolism, idiopathic event or unusual location. Patients without a detailed thrombophilia screening or who suffered from both ATE/VTE were excluded to find potential distinct thrombosis type specific thrombophilic risks. The possible role of “mild” factor accumulation was also investigated in VTE (n=266).Results: Elevation of factor VIII clotting activity was associated with VTE rather than ATE. Varicose veins together with postthrombotic syndrome were strongly related to several “mild” factors. Besides “severe” we found that the “mild” thrombophilic factors were also strongly associated with VTE/ATE. Comorbidities/conditions such as diabetes and smoking were generally associated with hyperlipidemia; moreover, both had a correlation with lipoprotein (a) in VTE. We also revealed an important contribution of “mild” factors in increasing trends of several types and localizations of VTE.Conclusion: In summary, besides the “severe” thrombophilic factors, the “mild” ones also seem to play a non-negligible role in the manifestation of thrombosis, especially in combination. Therefore, an extended screening might be useful in the personalized recommendation of antithrombotic prophylaxis.Keywords: thrombosis, hemostasis, thrombophilia, venous thromboembolism, arterial thromboembolism
