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CLINICAL STUDY

Prevalence of factor v leiden and prothrombin variant g20210a in patients age <50 years with no significant stenoses at angiography three to four weeks after myocardial infarction

Neil S. Van de Water, PhD^* , John K. French, MB, PhD, FESC^* , Mayanna Lund, MB, Thomas A. Hyde, MB, Harvey D. White, MB, DSc, FACC and Peter J. Browett, MB

^* Department of Molecular Medicine, University of Auckland, Auckland Hospital, Auckland, New Zealand
Hematology Department, Auckland Hospital, Auckland, New Zealand
Cardiology Department, Green Lane Hospital, Auckland, New Zealand

Manuscript received November 17, 1999; revised manuscript received March 1, 2000, accepted April 13, 2000.

Reprint requests and correspondence: Dr. John French, Cardiology Department, Green Lane Hospital, Private Bag 92 189, Auckland 1030, New Zealand
johnf{at}ahsl.co.nz

OBJECTIVES

We sought to determine the frequencies of factor V Leiden and prothrombin variant G20210A in patients age <50 years with no significant coronary stenoses three to four weeks after myocardial infarction (MI).

BACKGROUND

Factor V Leiden and prothrombin variant G20210A occur frequently in patients with venous thromboembolism. However, the contribution of these mutations to the development of MI requires clarification.

METHODS

The frequencies of factor V Leiden and prothrombin variant G20210A were determined in 41 patients age <50 years who had "normal" or "near normal" coronary arteries (no stenosis >50%) at angiography three to four weeks after MI (the study group) and compared with those in 114 patients who had at least one angiographic stenosis >50% after MI (the control group). Patients age 50 years with, or without, stenoses were also studied.

RESULTS

The frequency of factor V Leiden was 14.6% in patients age <50 years in the study group compared with 3.6% in patients in the control group (odds ratio [OR] 4.7 [95% confidence interval (CI) 1.3–17.7], p = 0.02). The frequency of the prothrombin variant G20210A was 7.3% in the study group compared with 1.8% in the control group (OR 4.4 [95% CI 0.7–27.5], p = 0.12). One or both mutations were present in 8 of the 41 patients (19.5%) age <50 years in the study group compared with 6 of the 114 patients (5.5%) in the control group (OR 4.4 [95% CI 1.4–13.5], p = 0.01). In all 271 patients (irrespective of age) with normal arteries, the frequency of factor V Leiden was 11.7% (7/60) compared with 4.3% (9/211) in patients with at least one >50% stenosis (OR 2.9 [95% CI 1.1–8.3], p = 0.04), and the frequency of prothrombin variant G20210A was 6.7% (4/60) compared with 1.4% (3/211) (OR 4.9 [95% CI 1.1–22.8], p = 0.04), respectively.

CONCLUSIONS

The frequencies of factor V Leiden and/or prothrombin variant G20210A are increased in patients age <50 years with normal or near normal coronary arteries after MI.

Abbreviations and Acronyms   CI = confidence interval   MI = myocardial infarction   OR = odds ratio   PCR = polymerase chain reaction

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