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Emmanuel Oger, Karine Lacut, Grgoire Le Gal, Patrick Van Dreden, Luc Bressollette, Pierre-Yves Scarabin, Christophe Leroyer, Dominique Mottier
Is APC Resistance a Risk Factor for Venous Thromboembolism in Patients over 70 Years?
Activated protein C (APC) resistance is the most common risk factor for venous thromboembolism (VTE). Previous studies mostly analysed patients under 70 years and reported a four- to sevenfold increased risk. This case-control study included consecutive patients referred for a clinical suspicion VTE to our medical unit: 621 patients with a well-documented diagnosis (cases) and 406 patients for which the diagnosis was ruled out and who had no personal history of VTE (controls). APC resistance related to factor V Leiden was defined by either a positive DNA analysis or a positive STA Staclot APC-R assay. Under 70 years, APC resistance was associated with a threefold increased risk of VTE (odds ratio 3.2, 95% CI, 1.7 to 6.0), whereas in patients over 70 years, it appeared to be no longer a strong risk factor (odds ratio 0.8, 95% CI, 0.4 to 1.7). Age appeared as an effect-measure modifier with a significant interaction (p = 0.005). Our data suggest that APC resistance is not a risk factor for VTE in elderly.
Thrombosis and Haemostasis, Schattauer
Print ISSN: 0340-6245
Volume: 88, 01/2002
Pages: 587 - 591