Méan Pascual, MarieMarieMéan PascualLimacher, AndreasAndreasLimacher0000-0002-9094-9476Stalder, OdileOdileStalderAngelillo, AnneAnneAngelilloAlberio, LorenzoLorenzoAlberioFontana, PierrePierreFontanaBeer, Hans-JürgHans-JürgBeerRodondi, NicolasNicolasRodondiLaemmle, BernhardBernhardLaemmleAujesky, DrahomirDrahomirAujesky2024-10-252024-10-252017-10https://boris-portal.unibe.ch/handle/20.500.12422/153615BACKGROUND The value of genetic thrombophilia testing in elderly patients with an unprovoked venous thromboembolism is unclear. We assessed whether the factor V Leiden and the prothrombin G20210A mutation are associated with recurrent venous thromboembolism in elderly patients in a prospective multicenter cohort study. METHODS We genotyped the factor V Leiden and the prothrombin G20210A mutation in 354 consecutive in- and outpatients aged ≥65 years with a first unprovoked venous thromboembolism from nine Swiss hospitals. Patients and managing physicians were blinded to testing results. The outcome was recurrent symptomatic venous thromboembolism during follow-up. We examined the association between the factor V Leiden and the prothrombin G20210A mutation and venous thromboembolism recurrence using competing risk regression, adjusting for age, sex, and periods of anticoagulation as a time-varying covariate. RESULTS Overall, 9.0% of patients had a factor V Leiden and 3.7% a prothrombin G20210A mutation. The At 36 months of follow-up, patients with a factor V Leiden and a prothrombin G20210A mutation had a cumulative incidence of recurrent venous thromboembolism of 12.9% (95% confidence interval [CI] 5.1-30.8%) and 18.5% (95% CI 4.9-56.5%), respectively, compared to 16.7% (95% CI 12.5-22.1%) of patients without mutation (P=0.91 by the log-rank test). After adjustment, neither the FV Leiden (sub-hazard ratio [SHR] 0.98; 95% CI 0.35-2.77) nor the prothrombin G20210A mutation (SRH 1.15; 95% CI 0.25-5.19) was associated with recurrent venous thromboembolism. CONCLUSION Our results suggest that testing for genetic thrombophilia may not be beneficial in elderly patients with a first unprovoked venous thromboembolism.enElderlyrecurrent venous thromboembolismthrombo philia / Angelillo-Scherrer Anne600 - Technology::610 - Medicine & health300 - Social sciences, sociology & anthropology::360 - Social problems & social servicesarticle10.7892/boris.1018092860679710.1016/j.amjmed.2017.05.026