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Activated partial thromboplastin time and risk of future venous thromboembolism.

TitleActivated partial thromboplastin time and risk of future venous thromboembolism.
Publication TypeJournal Article
Year of Publication2008
AuthorsZakai NA, Ohira T, White R, Folsom AR, Cushman M
JournalAm J Med
Volume121
Issue3
Pagination231-8
Date Published2008 Mar
ISSN1555-7162
KeywordsCohort Studies, Female, Humans, Male, Middle Aged, Partial Thromboplastin Time, Risk Factors, United States, Venous Thromboembolism
Abstract

BACKGROUND: Lower activated partial thromboplastin times are associated with higher levels of some coagulation factors and may represent a procoagulant tendency.

METHODS: In the Atherosclerosis Risk in Communities study, we studied the 13-year risk of venous thromboembolism in relation to baseline activated partial thromboplastin time in 13,880 individuals. We also studied 258 venous thromboembolism cases and 589 matched controls with measurements of additional coagulation factors.

RESULTS: After adjustment for demographics and procoagulant factors reflected in the activated partial thromboplastin time (fibrinogen, factors VIII, IX, and XI, and von Willebrand factor), participants in the lowest 2 quartiles of activated partial thromboplastin time compared with the fourth quartile had 2.4-fold (95% confidence interval [CI], 1.4-4.2) and 1.9-fold (95% CI, 1.1-3.2) higher risks of venous thromboembolism. The risk associated with activated partial thromboplastin times below the median was higher for idiopathic (odds ratio 5.5; 95% CI, 2.0-15.5) than secondary venous thromboembolism (odds ratio 1.74; 95% CI, 0.88-3.43). Subjects with both activated partial thromboplastin times below the median and factor V Leiden were 12.6-fold (95% CI, 5.7-28.0) more likely to develop venous thromboembolism compared with those with neither risk factor (P interaction<.01 a="" lower="" activated="" partial="" thromboplastin="" time="" also="" added="" to="" the="" thrombosis="" risk="" associated="" with="" obesity="" and="" elevated="" d-dimer.="">

CONCLUSION: A single determination of the activated partial thromboplastin time below the median increased the risk of future venous thromboembolism. Findings were independent of coagulation factor levels, and a low activated partial thromboplastin time added to the risk associated with other risk factors.

DOI10.1016/j.amjmed.2007.10.025
Alternate JournalAm J Med
PubMed ID18328308
PubMed Central IDPMC2295205
Grant ListN01HC55020 / HL / NHLBI NIH HHS / United States
N01 HC055022 / HC / NHLBI NIH HHS / United States
N01HC55018 / HL / NHLBI NIH HHS / United States
N01-HC-55022 / HC / NHLBI NIH HHS / United States
R01 HL059367 / HL / NHLBI NIH HHS / United States
N01-HC-55016 / HC / NHLBI NIH HHS / United States
N01 HC055018 / HC / NHLBI NIH HHS / United States
N01HC55022 / HL / NHLBI NIH HHS / United States
N01-HC-55021 / HC / NHLBI NIH HHS / United States
N01HC55015 / HL / NHLBI NIH HHS / United States
R01-HL-59367 / HL / NHLBI NIH HHS / United States
N01 HC055019 / HC / NHLBI NIH HHS / United States
N01-HC-55019 / HC / NHLBI NIH HHS / United States
R01 HL059367-08 / HL / NHLBI NIH HHS / United States
N01-HC-55015 / HC / NHLBI NIH HHS / United States
N01-HC-55020 / HC / NHLBI NIH HHS / United States
N01HC55016 / HL / NHLBI NIH HHS / United States
N01 HC055015 / HC / NHLBI NIH HHS / United States
N01 HC055021 / HC / NHLBI NIH HHS / United States
N01HC55019 / HL / NHLBI NIH HHS / United States
N01 HC055020 / HC / NHLBI NIH HHS / United States
N01-HC-55018 / HC / NHLBI NIH HHS / United States
N01HC55021 / HL / NHLBI NIH HHS / United States
N01 HC055016 / HC / NHLBI NIH HHS / United States