Abstract Number: OC 51.5
Meeting: ISTH 2022 Congress
Background: Risk factors for venous thrombosis (VT) include age, gender, genetics and life-style factors, e.g. oral contraceptive (OC) use. Thrombin generation (TG) correlates with a risk of VT.
Aims: We examined the association of TG with demographics, hormonal status and OC use in a large and well-characterised cohort of twins and family members. Using a cotwin-control design, the effect of OCs on TG within pairs discordant for OC use was determined.
Methods: TG data was available for 7,869 consenting participants (mean age: 45.1, range 18-98, 64.3% female) in the Netherlands Twin Register biobank. Data on demographics, hormonal status (incl. OC use) and medication use were obtained. TG was determined by calibrated automated thrombinography (CAT) in citrated plasma using 5 pM tissue factor (TF) and 4 µM phospholipids in the presence and absence of 20 nM thrombomodulin (TM). After excluding users of anticoagulants (n=101), TG was compared in men, women with a natural menstrual cycle, women using estrogen-containing OCs and post-menopausal women. TG differences were also examined in female monozygotic twins concordant (Nf306) and discordant (N = 152) for OC use.
Results: TG of women showed shorter lag-times, higher peak heights and higher endogenous thrombin potentials (ETPs) compared to men. Women using OCs had the most procoagulant TG profiles: higher ETP and peak, and shorter lag-time. All groups differed significantly, with post-menopausal women closer in value to men than women with a natural cycle. Similar patterns were seen in the presence of TM. The discordant cotwin-control analyses confirmed the OC effect: even after controlling for familial factors. OC use was associated with a less favorable profile (Table 1).
Conclusion(s): This study shows that factors known to increase VT risk (notably OC use) act by increasing TG. Our findings in discordant female monozygotic twin pairs provide strong evidence for a prothrombotic profile caused by OC use.
To cite this abstract in AMA style:Zwaveling S, Bloemen S, Castoldi E, de Geus E, Hottenga J, Hackeng T, Boomsma D, Hemker C, Willemsen G. Effects of gender and hormonal status on thrombin generation in a large population-based cohort of twins and their family members [abstract]. https://abstracts.isth.org/abstract/effects-of-gender-and-hormonal-status-on-thrombin-generation-in-a-large-population-based-cohort-of-twins-and-their-family-members/. Accessed October 2, 2023.
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