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Original Research: VENOUS THROMBOEMBOLISM |

Factors That Predict Risk of Thrombosis in Relatives of Patients With Unprovoked Venous Thromboembolism

Francis Couturaud, MD, PhD; Christophe Leroyer, MD, PhD; Jim A. Julian, Mmath; Susan R. Kahn, MD, MSc; Jeffrey S. Ginsberg, MD; Philip S. Wells, MD, MSc; James D. Douketis, MD, FCCP; Dominique Mottier, MD; Clive Kearon, MB, PhD
Author and Funding Information

Affiliations: From the Department of Internal Medicine and Chest Diseases (Drs. Couturaud, Leroyer, and Mottier), Groupe d'Etude de la Thrombose de Bretagne Occidentale, Brest, France; McMaster University and the Henderson Research Centre (Mr. Julian, and Drs. Ginsberg, Douketis, and Kearon), Hamilton, ON, Canada; McGill University (Dr. Kahn), Montreal, QC, Canada; and Ottawa University (Dr. Wells), Ottawa, ON, Canada.

Correspondence to: Francis Couturaud, MD, PhD, GETBO, EA 3878, Department of Internal Medicine and Chest Diseases, University Hospital Centre La Cavale Blanche, 29609 Brest cedex, France; e-mail: francis.couturaud@chu-brest.fr


Funding/Support: This study was supported by grants from Programme Hospitalier de Recherche Clinique, France, and the Heart and Stroke Foundation of Ontario. Dr. Kahn is a recipient of a Senior Clinical Investigator Award from the Fonds de la Recherche en Santé du Québec and receives grant support from the Heart and Stroke Foundation of Canada and the Canadian Institutes of Health Research; Dr. Ginsberg is a Career Investigator of the Heart and Stroke Foundation of Ontario and holds a David Braley and Nancy Gordon Chair in Thromboembolic Disease; Dr. Wells is supported by a Canada Research Chair and a Heart and Stroke of Ontario Program Grant; Dr. Kearon is supported by the Canadian Institutes of Health Research.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/site/misc/reprints.xhtml).


© 2009 American College of Chest Physicians


Chest. 2009;136(6):1537-1545. doi:10.1378/chest.09-0757
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Background:  Factors that predict the risk of venous thromboembolism in the first-degree relatives of patients with unprovoked venous thromboembolism are uncertain but important for counseling. We aimed to identify risk factors for, and quantify the risk of, venous thromboembolism in first-degree relatives of patients (index case patients) with a first episode of unprovoked venous thromboembolism.

Methods:  In a cross-sectional study, using a standardized method and without knowledge of whether patients or their relatives had thrombophilia, we assessed the prevalence of previous venous thromboembolism in 1,916 first-degree relatives of 378 unselected patients with a first episode of unprovoked venous thromboembolism. Patient characteristics, and the presence of factor V Leiden or the G20210A prothrombin gene mutation in patients, were assessed as predictors of venous thromboembolism in patient's relatives.

Results:  There were 102 previous episodes of venous thromboembolism in the first-degree relatives (prevalence, 5.3%). Thrombosis at a young age in patients was the strongest predictor of venous thromboembolism in relatives, with an adjusted odds ratio (OR) for younger patients (ie, patients < 45 years of age when venous thromboembolism occurred; lowest quartile) compared with older patients (ie, patients > 71 years of age; highest quartile) of 3.27 (95% CI, 1.68 to 6.38). The presence of factor V Leiden or the G20210A prothrombin gene in patients was a weak independent predictor of venous thromboembolism in relatives (adjusted OR, 1.48; 95% CI, 0.94 to 2.33).

Conclusion:  Unprovoked venous thromboembolism at a young age is associated with a substantially increased risk of venous thromboembolism in patients' families.

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