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Review ArticleClinical Review

Activated Protein C Resistance: The Most Common Risk Factor for Venous Thromboembolism

Dawn R. Sheppard
The Journal of the American Board of Family Practice March 2000, 13 (2) 111-115; DOI: https://doi.org/10.3122/15572625-13-2-111
Dawn R. Sheppard
From General Leonard Wood Army Community Hospital, Ft Leonard Wood, Mo.
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Abstract

Background: Venous thromboembolism is a major cause of morbidity and mortality. Although activated protein C resistance (APC-R) is the most commonly recognized inherited risk factor for venous thromboembolism, little is known about its long-tenn implications on health.

Methods: MEDLINE was searched from January 1989 through August 1999 using the key words “thromboembolism,” “thrombosis,” “activated protein C resistance,” and “factor V Leiden.”

Results: One in 1000 people in the United States is affected by venous thromboembolism annually. APC-R is now understood to be responsible for up to 64% of these cases. APC-R, which occurs widely in some ethnic groups and is nearly absent in others, is due to a single point mutation in the gene for clotting factor V. As a result, inactivation of factor V by activated protein C is impaired, leading to a hypercoagulable state. This condition creates a lifelong increased risk of thrombosis and, possibly, anticoagulant therapy..

Conclusion: Family physicians have a new tool for assessing risks for venous thromboembolism. Recognizing that up to 64% of patients with venous thromboembolism can have APC-R and treating this disorder with prophylactic and therapeutic anticoagulation might reduce patient morbidity and mortality from venous thromboembolism. Screening high-risk patients might now be indicated.

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The Journal of the American Board of Family     Practice: 13 (2)
The Journal of the American Board of Family Practice
Vol. 13, Issue 2
1 Mar 2000
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Activated Protein C Resistance: The Most Common Risk Factor for Venous Thromboembolism
Dawn R. Sheppard
The Journal of the American Board of Family Practice Mar 2000, 13 (2) 111-115; DOI: 10.3122/15572625-13-2-111

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Activated Protein C Resistance: The Most Common Risk Factor for Venous Thromboembolism
Dawn R. Sheppard
The Journal of the American Board of Family Practice Mar 2000, 13 (2) 111-115; DOI: 10.3122/15572625-13-2-111
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