Key result
Antithrombin deficiency was identified in 2.3% of patients with various forms of early-onset thrombosis, including 4% of those with venous thromboembolism and 2% of those with thrombosis associated with oral contraceptives or pregnancy.
Why the study?
Although antithrombin deficiency is an inherited risk factor for VTE, attention has focused more on F V Leiden and F II20210a mutations, prompting analysis of antithrombin deficiency frequency across patient cohorts.
Observational (n=1,315)
No
Antithrombin deficiency is present in approximately 2.3% of young patients with thrombosis, suggesting that targeted testing remains clinically useful in specific scenarios such as unprovoked VTE under 45 years of age or thrombosis associated with pregnancy and oral contraceptives.
Supports targeted antithrombin testing in select early-onset VTE cases; leaves open impact on outcomes.
PURPOSE: Antithrombin (AT) deficiency is a well-known inherited risk factor for venous thromboembolism (VTE). However, F V Leiden and F II20210a mutations have drawn much more attention in the recent years. Therefore, we have decided to analyze the frequency of antithrombin deficiency in different cohorts of patients and tried to formulate indications for its testing. RESULTS: Antithrombin deficiency was found in 4% of patients with recurrent VTE ≤ 50 years of age with, in 1% of patients with splanchnic vein thrombosis and in 2% of cases associated with combined oral contraceptives (COC) use or pregnancy. In patients with central venous thrombosis, antithrombin deficiency was not found. RECOMMENDATION: We consider antithrombin testing useful in patients with thrombosis occuring up to 45 years of age without any risk factors. Namely, females with VTE in pregnancy and puerperium should be tested as well as females with thrombosis on COC, if VTE occurred within the first year of their use. CONCLUSION: In spite of degressive interest in thrombophilia work up, we still consider antithrombin testing useful in defined clinical situations.
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Pejková et al. (2023) conducted an observational in Thrombosis (VTE, SVT, CVT, pregnancy/COC-associated) (n=1,315). Antithrombin deficiency was evaluated on Frequency of antithrombin deficiency. Antithrombin deficiency was identified in 2.3% of patients with various forms of early-onset thrombosis, including 4% of those with venous thromboembolism and 2% of those with thrombosis associated with oral contraceptives or pregnancy.
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