深部静脉血栓遗传危险因素.pptVIP

* * * * * * * * * * * Toshiyuki MIYATA, PhD National Cardiovascular Center Research Institute, Osaka, Japan the 19th Great Wall International Congress of Cardiology, October 24, 2008 Genetic risk factors for venous thromboembolism in Japanese Advanced age is a risk for venous thromboembolism (VTE) All VTE Blood, 110, 3097-3101, 2007 among residents of Olmsted County, Minnesota, from 1966 to 1990 PE DVT alone Male Female Incidence rates of VTE increase dramatically at about age 55, and, by age 80, are nearly 1 in 100 per year, approximately 1000-fold higher than for those aged 45 or younger. Risk factors for venous thromboembolismN Engl J Med, 358, 1037-52, 2008 Acquired factors Reduced mobility Advanced age Cancer Acute medical illness Major surgery Trauma Spinal cord injury Pregnancy and postpartum period Polycythemia vera Antiphospholipid antibody syndrome Oral contraceptives Hormone-replacement therapy Heparins Chemotherapy Obesity Central venous catheterization Immobilizer or cast Hereditary factors Antithrombin deficiency Protein C deficiency Protein S deficiency Factor V Leiden Prothrombin gene mutation Thrombo- modulin endothelium EPCR PC PS prothrombin FVa FXa FVa FVIIIa HSPG thrombin APC Protein C/protein S system Proteoglycan sulfate system Heparan sulfate FVi FVIIIi IIa AT Anticoagulant Systems on Endothelium Caucasian Japanese Factor V Leiden Prothrombin G20210A Deficiencies of protein C, protein S, antithrombin Low frequency variation Deficiencies of protein C, protein S, antithrombin Very rare mutation Genetic risk factors for venous thromboembolism Protein S K196E Tokyo General population, Suita study at NCVC VTE patients: Sub-group of Blood Coagulation Abnormality Study Group Suita, Osaka NCVC, Osaka U Nagoya U Jichi Med U Keio Univ Kyoto Pref Med U About 170 Japanese VTE patients Case-control study for VTE more than 3,500 individuals from a general population randomly selected from Suita city residents Kimura et al., Blood, 2006