TY - JOUR
T1 - Thrombophilia differences in splanchnic vein thrombosis and lower extremity deep venous thrombosis in North America
AU - Sutkowska, Edyta
AU - McBane, Robert D.
AU - Tafur, Alfonso J.
AU - Sutkowski, Krzysztof
AU - Grill, Diane E.
AU - Slusser, Joshua P.
AU - Wysokinski, Waldemar E.
N1 - Funding Information:
Biostatistical support was provided by an internal grant from the Mayo Clinic Division of Cardiology.
PY - 2013/10
Y1 - 2013/10
N2 - Background: The utility of thrombophilia testing in patients with splanchnic vein thrombosis (SpVT) has not previously been rigorously evaluated. The purpose of this study was to characterize differences in the prevalence of thrombophilia in patients with SpVT involving portal (PVT), mesenteric (MVT), splenic (SVT), or hepatic (HVT) veins in isolation or with multisegmental (M-SpVT) involvement compared to patients with lower extremity deep vein thrombosis (DVT). Methods: An inception cohort of patients with incident SpVT was identified for whom comprehensive thrombo-philia testing was performed between 1995 and 2005 and compared to DVT controls. Results: 341 patients with SpVT (mean age 50 ± 16 years, 53 % women) including isolated PVT (n = 112), MVT (n = 67), HVT (n = 22), SVT (n = 11), and M-SpVT (n = 129) involvement and 3621 DVT controls (mean age 55 ± 16 years, 56 % women) had comprehensive thrombophilia testing. The prevalence of abnormal results was similar for SpVT (24.6 %) and DVT (25.9 %) patients. "Strong" thrombophilias were more prevalent among SpVT patients (12.3 vs. 8.5 %, p = 0.0168). Patients with splenic (45.5 %) and mesenteric (41.8 %) thrombosis had the highest thrombophilia prevalence. Protein S deficiency was more common in SpVT patients (3.5 vs. 0.9 %, p < 0.001). In contrast, FV Leiden was more prevalent among DVT patients (15.8 vs. 10.9 %, p = 0.0497). Conclusion: The prevalence of selected thrombophilia factors differ comparing SpVT and DVT patients. The prevalence is particularly high for patients with splenic and mesenteric vein thrombosis. Whereby the finding of strong thrombophilia impacts duration of anticoagulant therapy, such testing is warranted in the evaluation of patients with unprovoked SpVT.
AB - Background: The utility of thrombophilia testing in patients with splanchnic vein thrombosis (SpVT) has not previously been rigorously evaluated. The purpose of this study was to characterize differences in the prevalence of thrombophilia in patients with SpVT involving portal (PVT), mesenteric (MVT), splenic (SVT), or hepatic (HVT) veins in isolation or with multisegmental (M-SpVT) involvement compared to patients with lower extremity deep vein thrombosis (DVT). Methods: An inception cohort of patients with incident SpVT was identified for whom comprehensive thrombo-philia testing was performed between 1995 and 2005 and compared to DVT controls. Results: 341 patients with SpVT (mean age 50 ± 16 years, 53 % women) including isolated PVT (n = 112), MVT (n = 67), HVT (n = 22), SVT (n = 11), and M-SpVT (n = 129) involvement and 3621 DVT controls (mean age 55 ± 16 years, 56 % women) had comprehensive thrombophilia testing. The prevalence of abnormal results was similar for SpVT (24.6 %) and DVT (25.9 %) patients. "Strong" thrombophilias were more prevalent among SpVT patients (12.3 vs. 8.5 %, p = 0.0168). Patients with splenic (45.5 %) and mesenteric (41.8 %) thrombosis had the highest thrombophilia prevalence. Protein S deficiency was more common in SpVT patients (3.5 vs. 0.9 %, p < 0.001). In contrast, FV Leiden was more prevalent among DVT patients (15.8 vs. 10.9 %, p = 0.0497). Conclusion: The prevalence of selected thrombophilia factors differ comparing SpVT and DVT patients. The prevalence is particularly high for patients with splenic and mesenteric vein thrombosis. Whereby the finding of strong thrombophilia impacts duration of anticoagulant therapy, such testing is warranted in the evaluation of patients with unprovoked SpVT.
KW - Hepatic vein thrombosis
KW - Mesenteric vein thrombosis
KW - Portal vein thrombosis
KW - Splenic vein thrombosis
KW - Thrombophilia
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U2 - 10.1007/s00535-012-0728-3
DO - 10.1007/s00535-012-0728-3
M3 - Article
C2 - 23247829
AN - SCOPUS:84892828851
SN - 0944-1174
VL - 48
SP - 1111
EP - 1118
JO - Journal of gastroenterology
JF - Journal of gastroenterology
IS - 10
ER -