Abstract Number: PB0053
Meeting: ISTH 2020 Congress
Theme: Arterial Thromboembolism » Cardiovascular Risk Factors
Background: Factor V Leiden (FVL) and factor II 20210G>A (FII20210) are the most common genetic risk factors for venous thromboembolism. The contribution of these markers to coronary artery disease (CAD) is less clear, with reported increased risks of small-moderate entity, or confined to patients with concomitant cardiovascular risk factors.
Aims: To investigate the association between FVL, FII20210 and premature CAD.
Methods: We performed a genetic case-control association study in the frame of the premature CAD Milano-Iran (MIran) study, a cohort of consecutive young patients (females < 55, males < 45 years) undergoing coronary angiography at the Tehran Heart Centre (Iran) in 2009-2012. Cases had coronary artery stenosis ≥50% and no history of myocardial infarction. Controls were age-, sex-matched individuals with no CAD history. FVL and FII20210 were genotyped using TaqMan SNP genotyping assays. Association testing was performed using logistic regression adjusting for matching factors and ethnicity. The modifier effect of sex and major cardiovascular risk factors (smoking, metabolic [at least one among obesity, hypertension, hyperlipidaemia, diabetes]) was also assessed.
Results: We genotyped 944 cases and 1081 controls (Table 1). The risk of premature CAD in FVL carriers was increased by 50% (OR 1.54 [95%CI 0.95-2.48]). Conversely, in FII20210 carriers it was decreased by almost 30% (OR 0.72 [95%CI 0.41-1.28]) (Table 2). These effects were more pronounced in women (FVL: OR 1.66 [95%CI 0.95-2.89]; FII20210: OR 0.61 [95%CI 0.30-1.25]) than men (FVL: OR 1.25 [95%CI 0.48-3.31]; FII20210: OR 1.07 [95%CI 0.39-2.91]). The risk of premature CAD was substantially increased when FVL and at least one major cardiovascular risk factor were present simultaneously, compared with non-carriers without cardiovascular risk factors (smoking: OR 4.44 [95%CI 1.17-16.86], metabolic: OR 24.60 [95%CI 12.27-49.34]).
Conclusions: FVL but not FII20210 is associated with an increased risk of CAD in young Iranians. This risk increases considerably when combined to other cardiovascular risk factors.
| Cases (n=944) | Controls (n=1081) | |
| Female sex, n (%) | 616 (65) | 756 (70) |
| Age, years, median (IQR) | 47 (43-52) | 45 (40-51) |
| Family history of CAD, n (%) | 411 (44) | 242 (23) |
| BMI, Kg/m2, median (IQR) | 29.2 (26.3-32.2) | 27.5 (24.8-31.0) |
| Diabetes mellitus, n (%) | 340 (36) | 125 (12) |
| Hyperlipidemia, n (%) | 707 (75) | 278 (26) |
| Hypertension, n (%) | 529 (56) | 159 (15) |
| Cigarette smoking, n (%) | 263 (28) | 139 (13) |
[Table 1. Baseline characteristics of study subjects.]
| Genotype | Cases (n=911) | Controls (n=1081) | OR (95% CI) | OR1 (95% CI) | |
| FVL | GG | 870 (95.5) | 1049 (97.0) | Reference | Reference |
| AG | 39 (4.3) | 31 (2.9) | 1.52 [0.94 to 2.45] | 1.49 [0.92 to 2.43] | |
| AA | 2 (0.2) | 1 (0.1) | 2.41 [0.22 to 26.64] | 3.05 [0.27 to 34.66] | |
| Carriers (AG + AA) | 41 (4.5) | 32 (3.0) | 1.55 [0.97 to 2.47] | 1.54 [0.95 to 2.48] | |
| FII20210 | GG | 916 (97.8) | 1050 (97.1) | Reference | Reference |
| AG | 19 (2.0) | 31 (2.9) | 0.70 [0.39 to 1.25] | 0.64 [0.35 to 1.16] | |
| AA | 2 (0.2) | 0 (0.0) | – | – | |
| Carriers (AG + AA) | 21 (2.2) | 31 (2.9) | 0.78 [0.44 to 1.36] | 0.72 [0.41 to 1.28] | |
| OR1: adjusted for sex, age and ethnicity. | |||||
[Table 2. Association of FVL and FII20210 variants with the occurrence of premature CAD.]
To cite this abstract in AMA style:
Mancini I, Sadeghian S, Pagliari MT, Abbasi SH, Poorhosseini H, Boroumand MA, Lotfi-Tokaldany M, Pappalardo E, Colombo G, Tafuri F, Agosti P, Rosendaal FR, Peyvandi F. Factor V Leiden but Not Factor II 20210G>A Is a Risk Factor in a Large Cohort of Iranian Patients with Premature Coronary Artery Disease [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/factor-v-leiden-but-not-factor-ii-20210ga-is-a-risk-factor-in-a-large-cohort-of-iranian-patients-with-premature-coronary-artery-disease/. Accessed November 29, 2023.« Back to ISTH 2020 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/factor-v-leiden-but-not-factor-ii-20210ga-is-a-risk-factor-in-a-large-cohort-of-iranian-patients-with-premature-coronary-artery-disease/