Serum Lipoprotein (a) Levels in Patients with First Unprovoked Venous Thromboembolism is not Associated with Subsequent Risk of Recurrent VTE

被引:12
作者
Rodger, M. A. [1 ,2 ]
Le Gal, G. [3 ,14 ]
Carrier, Marc [2 ]
Betancourt, M. T. [2 ]
Kahn, S. R. [4 ,5 ]
Wells, P. S. [2 ]
Anderson, D. A. [6 ]
Lacut, K. [3 ,14 ]
Chagnon, I. [7 ]
Solymoss, S. [4 ]
Crowther, M. [8 ]
Perrier, A. [9 ,10 ]
White, R. [11 ]
Vickars, L. [12 ]
Ramsay, T. [2 ]
Kovacs, M. J. [13 ]
机构
[1] Ottawa Hosp, Div Hematol, Res Inst, Clin Epidemiol Unit, Ottawa, ON K1H 8L6, Canada
[2] Univ Ottawa, Dept Med, Div Hematol, Thrombosis Program, Ottawa, ON, Canada
[3] Univ Hosp, Brest, France
[4] McGill Univ, Dept Med, Montreal, PQ, Canada
[5] McGill Univ, Jewish Gen Hosp, Ctr Clin Epidemiol & Community Studies, Montreal, PQ H3T 1E2, Canada
[6] Dalhousie Univ, Dept Med, Halifax, NS, Canada
[7] Univ Montreal, Dept Med, Hop Sacre Coeur Montreal, Montreal, PQ H3C 3J7, Canada
[8] McMaster Univ, Dept Med, Michael G DeGroote Sch Med, Hamilton, ON, Canada
[9] Univ Hosp Geneva, Dept Internal Med, Geneva, Switzerland
[10] Fac Med, Geneva, Switzerland
[11] UC Davis Sch Med, Dept Med, Sacramento, CA USA
[12] Univ British Columbia, Dept Med, St Pauls Hosp, Vancouver, BC, Canada
[13] Univ Western Ontario, Dept Med, Div Hematol, London, ON, Canada
[14] Dept Internal Med & Chest Dis, Brest, France
基金
加拿大健康研究院;
关键词
Lipoprotein a; Venous thrombosis; Risk factor; Anticoagulants; Cohort; ORAL ANTICOAGULANT-THERAPY; DEEP-VEIN THROMBOSIS; PULMONARY-EMBOLISM; FIRST EPISODE; CHOLESTEROL; FIBRINOLYSIS; BINDING; WOMEN;
D O I
10.1016/j.thromres.2010.06.007
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Introduction: Case-control studies suggest that elevated lipoprotein (a) (Lp(a)) is a risk factor for first venous thromboembolism (VTE). Lp(a) has not been prospectively investigated as a possible risk factor for recurrent VTE in first unprovoked VTE patients. We sought to determine if serum Lp(a) levels in patients with unprovoked VTE who discontinue anticoagulants after 5 to 7 months of therapy predict VTE recurrence in a prospective cohort study. Materials and Methods: Serum Lp(a) measurements were obtained from 510 first unprovoked VTE patients treated for 5 -7 months with anticoagulants in a 12 center study. Patients were subsequently followed for a mean of 16.9 months (SD +/- 11.2) for symptomatic VTE recurrence which was independently adjudicated with reference to baseline imaging. Results: There was no significant association between Lp(a) as a continuous variable and recurrent VTE nor in gender stratified subgroups. No statistically significant differences were observed in the median Lp(a) concentrations between patients who recurred and those who did not recur (median (interquartile range): 0.09 g/L (0.17) versus 0.06 g/L (0.11) respectively; p = 0.15). The Lp(a) cut-off point of 0.3 g/L was not significantly associated with recurrent VTE for the overall population nor in gender stratified subgroups. Conclusions: Elevated serum Lp(a) does not appear to be associated with recurrent VTE in patients with history of first unprovoked VTE and may not play a role in identifying patients with unprovoked VTE at high risk of recurrence. There was no optimal predictive threshold for the overall population or for sex sub-groups and Lp(a) >= 0.3 g/L was not a significant predictor of recurrent VTE. (C) 2010 Elsevier Ltd. All rights reserved.
引用
收藏
页码:222 / 226
页数:5
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