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Total tissue factor pathway inhibitor is an independent risk factor for symptomatic paediatric venous thromboembolism

Christine Duering1, Andrea Kosch, Claus Langer

  • 1Department of Paediatric Haematology and Oncology, University of Münster, Germany.

Thrombosis and Haemostasis
|October 7, 2004
PubMed

Insights

Lower tissue factor pathway inhibitor (TFPI) levels in children are linked to increased risk of symptomatic thromboembolism (ST). This finding suggests TFPI may be a key biomarker for pediatric clotting disorders.

Area of Science:

  • Hematology
  • Pediatric Thrombosis
  • Coagulation Factors

Background:

  • Tissue factor pathway inhibitor (TFPI) is crucial for regulating coagulation.
  • Reduced TFPI levels have been observed in adults with venous thrombosis (VT) and ischemic stroke (IS).
  • The role of TFPI in pediatric symptomatic thromboembolism (ST) requires further investigation.

Purpose of the Study:

  • To investigate whether decreased TFPI concentrations are associated with pediatric symptomatic thromboembolism (ST).
  • To evaluate TFPI levels as a potential risk factor for ST in children.

Main Methods:

  • A case-control study involving 144 children (0.6-18 years) with VT or IS and 244 healthy controls.
  • Total TFPI concentrations were measured 6-12 months post-thrombosis.
  • Age-dependent 10th percentiles from controls defined low TFPI levels.

Main Results:

  • Median TFPI levels were significantly lower in pediatric patients with ST compared to controls (p < 0.0001).
  • 29.2% of patients had TFPI levels below the 10th percentile, versus 10.2% of controls.
  • Low TFPI levels (<10th percentile) were independently associated with a 3.8-fold increased risk of ST in children (OR: 3.8; 95% CI: 2.2-6.6).

Conclusions:

  • Total TFPI concentrations below the 10th age-dependent percentile are an independent risk factor for symptomatic thromboembolism in Caucasian children.
  • This finding highlights TFPI as a potential biomarker for identifying children at higher risk of clotting disorders.

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