Source: Annual Congress 2006 - Pulmonary hypertension: thromo-embolic processes

Abstract

Aim: To examine the epidemiological characteristics and search for differences of acquired and inherited factors between cases of idiopathic (IPE) and secondary pulmonary embolism (SPE) in our area (North-Western Creece) during the last 4 years.
Material and Methods: The study group consists of 123 patients (62±14.8 years) presented in the emergencies with high PE probability. PE was confirmed on 74/123 pts (60%), 36 (49 %) were classified as IPE and 38 as SPE (51 %) according to the co-existence of cancer, lymphoma, antiphospholipid syndrome, recent trauma or operation and /or prolonged immobilization.
Results: IPE and SPE groups were not significantly different for sex and age. Fibrinogen levels, protein S and C, AT, and LDH activities are also similar between the two groups. During the follow-up one death occurred that attributed to secondary P.E.
Common thrombophilia mutations were always found in higher frequency among IPE than SPE. Heterozygosity for factor V Leiden (20.7% on IPE versus 0% on SPE), heterozygosity for prothrombin gene mutation G20210A (24.1 % on IPE versus 5.7 % on SPE) and homozygocity for C677T of MTHFR (24.1 % on IPE 11.4 % on SPE).
The heterozygous for prothrombin G20210A seems to carry the most important inherited risk factor for IPE in comparison to normal healthy controls (O.R.= 11.6 95% C.I=.3,8 to 35,0)
Conclusions: IPE and SPE are presented in almost similar rates. Genetic mutation are significantly more frequent in the IPE group with the heterozygocity for prothrombin G20210A gene being the most striking genetic risk factor.

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G. C. H. Maglaras, L. S. Dova, G. G. Baxevanos, C. A. Katsanos, G. A. Vartholomatos, N. I. Kolaitis, Z. M. Metafratzi, S. H. Constantopoulos, M. P. Vassiliou (Ioannina, Greece). Acquired and inherited risk factors in cases of idiopathic and secondary pulmonary embolism in North-Western Greece. Eur Respir J 2006; 28: Suppl. 50, 2359

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