Lung

, Volume 186, Issue 1, pp 27–36

Impact of Thrombophilic Genetic Factors on Pulmonary Embolism: Early Onset and Recurrent Incidences

  • Petar Ivanov
  • Regina Komsa-Penkova
  • Katia Kovacheva
  • Yavor Ivanov
  • Angelina Stoyanova
  • Ivan Ivanov
  • Plamen Pavlov
  • Pavlina Glogovska
  • Venzislav Nojarov
Article

DOI: 10.1007/s00408-007-9061-7

Cite this article as:
Ivanov, P., Komsa-Penkova, R., Kovacheva, K. et al. Lung (2008) 186: 27. doi:10.1007/s00408-007-9061-7

Abstract

The importance of genetic thrombophilic factors in the development of venous thromboembolism has been increasingly recognized. Factor V Leiden (FVL), prothrombin gene mutation G20210A (FII G20210), genetic variant C677T of the methylentetrahydrofolate reductase (MTHFR), as well as the polymorphism A2 (PlA2) in platelet glycoprotein IIb/IIIa were recently discussed. We analyzed the contribution of genetic thrombophilic factors to the pathogenesis of pulmonary embolism (PE) and their association with the early onset and recurrence of PE using DNA analysis methods. In this case control trial we found thrombophilic genetic variants in 58.8% of 51 patients with PE. FVL was found in 23.5% of the patients versus 7.1% of the 98 controls (p = 0.01), PlA2 IIb/IIIa was found in 35.3% vs. 14.3% (p = 0.03), and FII G20210A was found in 5.9% vs. 2.0% (NS). Patients with recurrent PE had a very high prevalence of genetic factors, 70.4%. High prevalence of FVL was found in patients under 45 years of age: 39.3% (OR = 14.23, 95% CI = 1.58–330.03, p = 0.01) as well as in patients with recurrent incidence (37%, OR = 7.647, 95% CI = 2.27–26.44, p = 0.001). FVL was also significantly higher in the subgroup of patients with PE combined with deep venous thrombosis (OR = 6.500, 95% CI = 1.81–23.76, p = 0.002) in comparison with patients with isolated PE (OR = 2.261, 95% CI = 0.50–9.69). The carriers of FVL are at higher risk for early and recurrent PE events. High prevalence of PlA2 in PE patients evidently shows the impact of this polymorphism in PE development. A different treatment should be considered in carriers of thrombophilic defects.

Keywords

Inherited thrombophilic genetic factorsPulmonary embolismRisk of early and recurrent onset

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Petar Ivanov
    • 1
  • Regina Komsa-Penkova
    • 1
  • Katia Kovacheva
    • 2
  • Yavor Ivanov
    • 3
  • Angelina Stoyanova
    • 1
  • Ivan Ivanov
    • 1
  • Plamen Pavlov
    • 3
  • Pavlina Glogovska
    • 3
  • Venzislav Nojarov
    • 3
  1. 1.Department of BiochemistryUniversity of MedicinePlevenBulgaria
  2. 2.Medical GeneticsUniversity of MedicinePlevenBulgaria
  3. 3.University Lung Diseases Hospital, University of MedicinePlevenBulgaria