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Thromb Haemost 2010; 103(04): 749-756
DOI: 10.1160/TH09-09-0645
Blood Coagulation, Fibrinolysis and Cellular Haemostasis
Schattauer GmbH

A meta-analysis of potential risks of low levels of protein Z for diseases related to vascular thrombosis

Francesco Sofi
1   Department of Medical and Surgical Critical Care, Thrombosis Centre, University of Florence, Italy
2   Don Carlo Gnocchi Foundation, Centro S. Maria agli Ulivi, Onlus IRCCS, Florence; Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
,
Francesca Cesari
1   Department of Medical and Surgical Critical Care, Thrombosis Centre, University of Florence, Italy
,
Rosanna Abbate
1   Department of Medical and Surgical Critical Care, Thrombosis Centre, University of Florence, Italy
,
Franco Gensini
1   Department of Medical and Surgical Critical Care, Thrombosis Centre, University of Florence, Italy
2   Don Carlo Gnocchi Foundation, Centro S. Maria agli Ulivi, Onlus IRCCS, Florence; Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
,
George Broze Jr
3   Division of Hematology, Washington University, St. Louis, Missouri, USA
,
Sandra Fedi
1   Department of Medical and Surgical Critical Care, Thrombosis Centre, University of Florence, Italy
› Author Affiliations
Further Information

Publication History

Received: 15 September 2009

Accepted after major revision: 22 January 2009

Publication Date:
22 November 2017 (online)

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Summary

The relationship between protein Z levels and thrombosis is controversial. We performed a systematic review and meta-analysis of the available studies to assess the association between protein Z and vascular thrombotic diseases. We conducted an electronic literature search through MedLine, Embase, Google Scholar, Web of Science, The Cochrane Library, bibliographies of retrieved articles and abstracts of congresses up to October, 2009. Studies were included if they analysed protein Z levels in patients with vascular thrombotic diseases. After the review process, 28 case-control studies (33 patient cohorts), including 4,218 patients with thrombotic diseases and 4,778 controls, were selected for analysis. The overall analysis using a random-effects model showed that low protein Z levels were associated with an increased risk of thrombosis (odds ratio [OR] 2.90, 95% confidence interval [CI] 2.05–4.12; p<0.00001). On subgroup analysis, a significant association was found between low protein Z levels and arterial vascular diseases (OR 2.67, 95%CI 1.60–4.48; p=0.0002), pregnancy complications (OR 4.17, 95%CI 2.31–7.52; p<0.00001), and venous thromboembolic diseases (OR 2.18, 95%CI 1.19–4.00; p=0.01). The results of this meta-analysis are consistent with a role for protein Z deficiency in thrombotic diseases, including arterial thrombosis, pregnancy complications and venous thromboembolism.

Keywords

Protein Z - thrombosis - coagulation - meta-analysis

 

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