Thrombophilia and the risk of thromboembolic events in women on oral contraceptives and hormone replacement therapy

被引:14
|
作者
DeSancho, Maria T. [1 ,2 ]
Dorff, Tanya [3 ]
Rand, Jacob H. [4 ,5 ,6 ]
机构
[1] New York Presbyterian Hosp Cornell Med Ctr, Div Hematol & Med Oncol, Dept Med, New York, NY 10021 USA
[2] Cornell Univ, Weill Med Coll, New York, NY 10021 USA
[3] USC Keck Sch Med, Los Angeles, CA USA
[4] Montefiore Med Ctr, Albert Einstein Coll Med, Bronx, NY 10467 USA
[5] Montefiore Med Ctr, Dept Pathol, Bronx, NY 10467 USA
[6] Montefiore Med Ctr, Dept Med, Bronx, NY 10467 USA
关键词
oral contraceptives; hormone replacement therapy; thrombophilia; thrombosis; FACTOR-V-LEIDEN; VENOUS THROMBOEMBOLISM; ISCHEMIC-STROKE; FAMILY-HISTORY; THROMBOSIS; RESISTANCE; ARTERIAL; MUTATION;
D O I
10.1097/MBC.0b013e32833b2b84
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Thrombophilia contributes to the risk of thrombosis in women using female hormones. The objective of the present study was to evaluate the prevalence of thrombophilia in women with thromboembolic events (TEEs) using oral contraceptives or hormone replacement therapy (HRT) and assess the contribution of a family history and the duration of hormone use in predicting thrombosis. A retrospective analysis was performed of the case records of women who developed a TEE while on oral contraceptives or HRT and were referred for thrombophilia evaluation over a 4-year period. Among 85 women who developed a TEE while on oral contraceptives or HRT, 65 had at least one additional thrombophilia risk factor. Of the 85 cases, 23 tested positive for more than two thrombophilias, 16 had factor V Leiden, five had the prothrombin gene G20210A polymorphism, 26 had antiphospholipid antibodies, 10 had elevated homocysteine, four had protein C deficiency, and seven had protein S deficiency. There were 64 TEE: 16 pulmonary emboli, 17 cerebrovascular events, 11 intra-abdominal thromboses, 13 deep venous thromboses, five cases of superficial thrombophlebitis, and two retinal vein thromboses. Of the 65 women, 37% had a positive family history of thrombosis. Approximately half of the women had been taking oral contraceptives or HRT for more than 1 year. There is a high prevalence of thrombophilia in women who developed a TEE while using oral contraceptives or HRT for more than 1 year. Family and personal history of thrombosis should be carefully evaluated in all women before initiating or continuing oral contraceptives or HRT, and a positive history may warrant a thrombophilia screening. Blood Coagul Fibrinolysis 21:534-538 (C) 2010 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.
引用
收藏
页码:534 / 538
页数:5
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