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Patients with persistent APC-resistance without factor V Leiden mutation.

T Schwarz1, G Siegert, U Mikulin

  • 1Department of Internal Medicine, University of Dresden, Germany.

VASA. Zeitschrift Fur Gefasskrankheiten
|April 4, 2001
PubMed
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Activated protein C (APC) resistance, not linked to factor V Leiden, can be reversible or persistent. This finding suggests distinct patient subsets and implications for thrombotic risk assessment.

Area of Science:

  • Hematology
  • Thrombosis Research
  • Genetic Thrombophilia

Background:

  • Activated protein C (APC) resistance and factor V Leiden are key risk factors for deep venous thrombosis (DVT).
  • The association between coagulation phenotype and genetic defects is well-established, but APC resistance without factor V Leiden is less understood.
  • The clinical significance and thrombotic risk of APC resistance independent of factor V Leiden remain unclear.

Purpose of the Study:

  • To investigate the prevalence and characteristics of APC resistance in patients with thrombotic events.
  • To determine if APC resistance can occur independently of the factor V Leiden mutation.
  • To explore the implications of non-factor V Leiden-associated APC resistance on thrombotic risk.

Main Methods:

Related Experiment Videos

  • Tested 486 consecutive patients for APC resistance using a factor VIII-based assay.
  • Assessed patients presenting with deep venous thrombosis, arterial disease, or other non-vascular conditions.
  • Monitored APC resistance status over 12 months in patients with initial pathological APC resistance.

    • Main Results:

    • 31% of patients (149/486) exhibited pathological APC resistance.
    • The assay demonstrated 100% sensitivity and 40% specificity for detecting factor V Leiden.
    • In patients with initial pathological APC resistance, 55% normalized by 6 months, while 91% remained pathological at 12 months.

    Conclusions:

    • APC resistance not caused by factor V Leiden can be categorized into reversible and persistent forms.
    • Reversible APC resistance may indicate a transient hypercoagulable state during acute thrombosis.
    • Persistent APC resistance suggests a distinct underlying condition requiring further investigation for thrombotic risk stratification.