Absolute risk of venous and arterial thromboembolism in thrombophilic families is not increased by high thrombin-activatable fibrinolysis inhibitor (TAFI) levels

Nienke Folkeringa; Michiel Coppens; Nic J. G. M. veeger; Victor J. J. Bom; Saskia Middeldorp; Karly Hamulyak; Martin H. Prins; Harry R. Büller; Jan van der Meer

doi:10.1160/TH07-11-0659

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2008; 100(01): 38-44
DOI: 10.1160/TH07-11-0659

Blood Coagulation, Fibrinolysis and Cellular Haemostasis

Schattauer GmbH

Absolute risk of venous and arterial thromboembolism in thrombophilic families is not increased by high thrombin-activatable fibrinolysis inhibitor (TAFI) levels

Nienke Folkeringa

¹Division of Haemostasis, Thrombosis and Rheology, Department of Haematology, University Medical Center Groningen, The Netherlands

,

Michiel Coppens

²Department of Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands

,

Nic J. G. M. veeger

¹Division of Haemostasis, Thrombosis and Rheology, Department of Haematology, University Medical Center Groningen, The Netherlands

,

Victor J. J. Bom

³Department of Pathology and Laboratory Medicine, University Medical Center Groningen, The Netherlands

,

Saskia Middeldorp

²Department of Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands

,

Karly Hamulyak

⁴Department of Hematology, University Hospital Maastricht, The Netherlands

,

Martin H. Prins

⁵Department of Clinical Epidemiology and Medical Technology Assessment, University Hospital Maastricht, The Netherlands

,

Harry R. Büller

²Department of Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands

,

Jan van der Meer

¹Division of Haemostasis, Thrombosis and Rheology, Department of Haematology, University Medical Center Groningen, The Netherlands

› Author Affiliations

Abstract

Summary

High levels of thrombin-activatable fibrinolysis inhibitor (TAFI) are a supposed risk factor for thrombosis. However, results from previous studies are conflicting. We assessed the absolute risk of venous and arterial thromboembolism in subjects with high TAFI levels (>126 U/dl) versus subjects with normal levels, and the contribution of other concomitant thrombophilic defects. Relatives from four identical cohort studies in families with either deficiencies of antithrombin, protein C or protein S, prothrombin 20210A, high factor VIII levels, or hyperhomocysteinemia were pooled. Probands were excluded. Of 1,940 relatives, 187 had high TAFI levels. Annual incidences of venous thromboembolism were 0.23% in relatives with high TAFI levels versus 0.26% in relatives with normal TAFI levels (adjusted relative risk [RR] 0.8; 95% confidence interval [CI], 0.5–1.3). For arterial thrombosis these were 0.31% versus 0.23% (adjusted RR 1.4; 95% CI, 0.9–2.2). High levels of factor VIII, IX and XI were observed more frequently in relatives with high TAFI levels. Only high factor VIII levels were associated with an increased risk of venous and arterial thrombosis, independently of TAFI levels. None of these concomitant defects showed interaction with high TAFI levels. High TAFI levels were not associated with an increased risk of venous and arterial thromboembolism in thrombophilic families.

Keywords

Arterial thromboembolism - TAFI - venous thromboembolism

Full Text

References

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