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Acta Phlebologica 2012 December;13(3):125-30

Copyright © 2013 EDIZIONI MINERVA MEDICA

language: English

Thrombophilia and vascular disease: indication to treatment of asymptomatic patients

Aluigi L. ¹, Antignani P. L. ²

¹ Department of Internal Medicine, Centre and School of Ultrasound Applications, Major Hospital, Bologna, Italy; ² Department of Angiology, S. Giovanni Hospital, Rome, Italy

Venous thromboembolism (VTE) is a common source of morbidity and mortality in Western countries. The term thrombophilia describes a tendency to develop thrombosis on the basis of inherited or aquired disorders of blood coagulation or fibrinolyisis leading to a prothrombotic state. Heritable risk factors for VTE can be identified in 30–50% of affected patients: among these Factor V Leiden, prothrombin 20210G>A, and deficiencies of antithrombin, protein C and protein S more frequently increase the risk of a first VTE. Non-modifiable risk factors such as advancing age and family history also increase thrombotic risk as like as many other acquired risk factors. Thus venous thromboembolic disease is now viewed as a multicausal model, the thrombotic event being the result of gene-gene and gene-environment interactions (for instance dietary habits, travel or circumstantial risk factors such as surgery, trauma, pregnancy and puerperium and oral contraceptive intake). An evidence-based risk factor evaluation is an essential step in VTE prevention and for management of asymptomatic subjects