The acute phase reaction explains only a part of initially elevated factor VIII:C levels: A prospective cohort study in patients with venous thrombosis

We determined in a prospective cohort of patients treated with vitamin K antagonists for venous thrombosis, the course of factor VIII (FVIII: C), C-reactive protein (CRP) and fibrinogen levels, to assess the influence of the acute phase reaction on FVIII: C levels. Second, we hypothesized that patients with preceding infectious symptoms might have higher levels of FVIII: C at baseline than patients without those. We included 75 patients. Blood was sampled at baseline, once during treatment (t=1) and at the end of treatment (t=2). Mean levels of FVIII: C were 207, 186 and 175 IU/dL (p for trend 0.003) at baseline, t=1 and t=2 respectively. Eight-eight percent of patients had an elevated FVIII: C at baseline, 75% at t=1 and 72% at t=2 (p for trend 0.045). Mean levels of FVIII: C were not different in patients with or without preceding infectious symptoms (206 versus 205 IU/dL respectively). A baseline CRP level below 62 mg/L could best distinguish between patients who will keep an elevated FVIII: C and those who will drop below 150 IU/dL. We conclude that FVIII: C levels are partially influenced by the acute phase reaction, especially in patients who keep a persistent elevated FVIII: C during treatment. Preceding infectious symptoms did not influence baseline FVIII: C levels. (C) 2011 Elsevier Ltd. All rights reserved.