Clinical Investigation of Hereditary and Acquired Thrombophilic Factors in Patients with Venous and Arterial Thromboembolism

Figures & data

Table 1 Summary of the Principal Component Analyses

Factor Groups	Explained Variance		Sum of the First Two PrCs	KMO	Bartlett Test
	PrC1	PrC2			Chi2 (df)**	P
Localization of thromboses	43.44%	26.89%	70.33%	0.678	82.8 (28)	<0.001
Accompanied diseases	54.35%	35.27%	89.62%	0.855	119.4 (21)	<0.001

Note: **Chi-squared test.

Abbreviations: KMO, Kaiser-Meyer-Olkin test for measuring adequacy; PrC1, Principal Component 1; PrC2, Principal Component 2; df, degrees of freedom.

Table 2 Clinical Characteristics of Patients with VTE/ATE

VTE (266 Patients)		ATE (82 Patients)
Distribution of diagnoses
Distal deep vein thrombosis	36%	Anterior ischemic optic neuropathy/retinal artery thrombosis	41%
Proximal deep vein thrombosis	32%	Transient ischemic attack	33%
Pulmonary embolism	26%	Peripheral artery disease	32%
Central retinal vein thrombosis	18%	Ischemic Stroke	29%
Upper extremity deep vein thrombosis	18%	Acute myocardial infarction	15%
Pulmonary embolism and deep vein thrombosis at the same time	11%
Splanchnic vein thrombosis	6%
Cerebral venous sinus thrombosis	3%
Risk factors and comorbidities
Age	53.38y±16.84		54.45y±15.38
Gender ♂	35%		50%*
Age at first thrombosis	39.77y±16.35		48.02y±14.99*
Smoking	12%		33%*
Recurrent events	41%		23%*
Provoking factor	44%		5%*
Varicose veins	16%		1%*
Postthrombotic syndrome	31%		0%*
Positive family history	56%		63%
Hyperlipidemia	61%		70%
Diabetes mellitus	15%		18%
Autoimmune disease	37%		28%
Hypo/hyperthyroidism	13%		13%
Laboratory factors
Homocysteine↑	39%		51%
vWF:Ag↑	45%		33%
Lp(a)↑	31%		33%
FVIII:C↑	44%		28%*
MTHFR heterozygous	17%		26%
MTHFR homozygous	5%		3%
aCL antibodies	16%		13%
FVLeiden heterozygous	27%		20%
aB2GPI antibodies	9%		7%
FII heterozygous	13%		16%
PC deficiency (SF)	5%		7%
Lupus anticoagulant (SF)	5%		4%
PS deficiency (SF)	7%		3%
FVLeiden homozygous (SF)	3%		2%
AT deficiency (SF)	4%		2%
FII homozygous (SF)	1%		0%

Notes: *p<0.05. Antithrombin (AT) deficiency: AT activity <80%, Protein C (PC) deficiency: PC activity <70%, Protein S (PS) deficiency: PS activity <60%, factor VIII clotting activity (FVIII:C) ↑: FVIII:C >150%, von Willebrand factor antigen (vWF:Ag) ↑: vWF:Ag >160%, homocysteine ↑: homocysteine to > 12.5 µmol/L, lipoprotein(a) (Lp(a)) ↑: Lp(a) >300 mg/L, anti-cardiolipin antibodies: aCL IgG/IgM > 20 U/mL, anti-beta-2-glycoprotein I antibodies: aB2GPI antibodies IgG/IgM > 20 U/mL, FII: prothrombin G20210A polymorphism. It is to be noted that n=131 patents had combined thrombotic diseases.

Abbreviations: FVLeiden, factor V Leiden p.R2506Q mutation; MTHFR, methylenetetrahydrofolate reductase; SF, serious factor.

Figure 1 Relationship of thrombophilic factors and comorbidities/condition.

Abbreviations: FII20210A, prothrombin G20210A polymorphism; FVLeiden, factor V Leiden p.R2506Q mutation; FVIII:C, factor VIII clotting activity; Lp(a), lipoprotein (a); vWF:Ag, von Willebrand factor antigen; MTHFR, methylenetetrahydrofolate reductase C677T polymorphism; PrC1, Principal Component 2; PrC2, Principal Component 2.

Figure 2 Relationship of thrombophilic factors and different types of thromboses.

Abbreviations: FII20210A, prothrombin G20210A polymorphism; FVLeiden, factor V Leiden p.R2506Q mutation; FVIII:C, factor VIII clotting activity; Lp(a), lipoprotein (a); vWF:Ag, von Willebrand factor antigen; MTHFR, methylenetetrahydrofolate reductase C677T polymorphism; PrC1, Principal Component 1; PrC2, Principal Component 2.

Table 3 Comparison of Mild and Severe Groups According to Thromboembolic Events and Thrombophilia Lab Factors

Lab Factors	VTE	Mild Groups			Severe Groups
		MF1	MF2	MF3	SF1	SF2	SF3
FVLeiden heterozygous	Proximal DVT	0.148	0.241	0.277	–	–	–
Homocysteine		0.107*	0.176	0.228	0.071*	0.200	0.261
FVIII:C		0.000*	0.160	0.431	0.125*	0.145	0.667
MTHFR heterozygous		0.000*	0.150	0.194	–	–	–
PS deficiency		–	–	–	0.357	0.400	0.500
aCL		–	–	–	0.000*	0.111*	0.316
vWF:Ag		0.000*	0.036*	0.365	0.000*	0.000*	0.615
Lp(a)		–	–	–	0.062*	0.167	0.278
FVLeiden heterozygous	Distal DVT	0.143	0.225	0.270	–	–	–
Homocysteine		–	–	–	0.000*	0.300	0.471
FII heterozygous		–	–	–	0.000*	0.143	0.556
FVIII:C		–	–	–	0.167	0.200	0.375
Lp(a)		–	–	–	0.062*	0.167	0.278
MTHFR heterozygous		–	–	–	0.000*	0.167	0.231
PC deficiency		–	–	–	0.083*	0.083*	0.143
Lupus anticoagulant		–	–	–	0.059*	0.286	0.357
aCL		–	–	–	0.000*	0.429	0.467
aB2GPI		–	–	–	0.000*	0.167	0.545
vWF:Ag		–	–	–	0.000*	0.250	0.615
AT deficiency		–	–	–	0.000*	0.167	0.333
Homocysteine	CRVO	–	0.188	0.380	–	–	–
FVIII:C		–	0.107*	0.167	–	–	–
Lp(a)		–	0.125*	0.257	–	–	–
MTHFR heterozygous		–	–	–	0.000*	0.000*	0.182
Homocysteine	PE	–	–	–	0.077*	0.222	0.263
PS deficiency		–	–	–	0.188	0.400	0.375
PS deficiency	PE+DVT	–	–	–	0.154	0.250	0.255
FVLeiden homozygous	Cerebral sinus thrombosis	–	–	–	0.000*	0.000*	0.333

Note: *Not significant at 5% significance level, critical value: 0.135 (significant indices above 0.135 are unmarked).

Abbreviations: FII, prothrombin G20210A polymorphism; FVLeiden, factor V Leiden p.R2506Q mutation; FVIII,C, factor VIII clotting activity; Lp(a), lipoprotein (a); AT, antithrombin deficiency; PC, Protein C deficiency; PS, Protein S deficiency; vWF,Ag, von Willebrand factor antigen; aCL, anti-cardiolipin antibodies; aB2GPI, anti-beta-2-glycoprotein I antibodies; MTHFR, methylenetetrahydrofolate reductase C677T polymorphism; DVT, deep vein thrombosis; CRVO, central retinal vein thrombosis; PE, pulmonary embolism; PE+DVT, pulmonary embolism and deep vein thrombosis at the same time; MF1, mild 1 group; MF2, mild 2 group; MF3, mild 3 group; SF1, severe 1 group; SF2, severe 2 group; SF3, severe 3 group.

Data Sharing Statement

The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.