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Thromb Haemost 2006; 95(04): 728-734
DOI: 10.1160/TH05-08-0593
New Technologies, Diagnostic Tools and Drugs
Schattauer GmbH

Comparison of three activated protein C resistance tests in the risk assessment of venous thrombosis in non-carriers of the factor V Leiden mutation

Felipe Guerrero
1   Laboratoire de Recherche sur la Thrombose, EA 2049, Laboratoire d’Hématologie, Hôpital Rangueil
,
Catherine Arnaud
2   Laboratoire d’épidémiologie, Equipe «Méthodes en Recherche Clinique», CHU Toulouse;Toulouse cedex, France
,
Francoise Nguyen
1   Laboratoire de Recherche sur la Thrombose, EA 2049, Laboratoire d’Hématologie, Hôpital Rangueil
,
Bernard Boneu
1   Laboratoire de Recherche sur la Thrombose, EA 2049, Laboratoire d’Hématologie, Hôpital Rangueil
,
Pierre Sié
1   Laboratoire de Recherche sur la Thrombose, EA 2049, Laboratoire d’Hématologie, Hôpital Rangueil
› Author AffiliationsFinancial support: The FITE-NAT study was supported by a grant from the CNP Insurance Company and Sanofi Synthelabo-France.
Further Information

Publication History

Received 31 August 2005

Accepted after resubmission 07 February 2006

Publication Date:
30 November 2017 (online)

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Summary

Activated protein C resistance (APCR), measured using the original assay described by Dahlbäck, is a risk factor for venous thrombosis independent of the factor V Leiden (FVL) mutation. This assay is based on the activated partial thromboplastin time (APTT) after plasma exposure to activated protein C (APC).As this assay was sensitive to numerous interferences, new assays have been developed for FVL screening. The objectives of the study were to investigate the association of second generation assays for APCR with venous thrombosis in FVL non-carriers. One hundred ninety-seven subjects with a history of venous thrombosis and 211 controls were explored using 3 APCR assays, the original APTT-based assay (test A), an APTT-based assay with factorV depleted plasma pre-dilution (test B) and a direct factorX activation-based assay with the same pre-dilution (test C).We found that subjects with results in the lowest quartile of the APTT-based assays are at increased risk, compared to those in the highest quartile (test A Odds Ratio = 6.39; 95%CI 3.23–12.63; test B OR=2.72; 95%CI 1.50–4.94). There was no significant risk increase associated with test C results. After adjusting for FVIII levels, the ORs of tests A and B were similar (test A OR=3.22; 95%CI 1.47–7.08; test B OR=3.10; 95%CI 1.54–6.21). In conclusion, APTT-based assays, but not direct factor X activation-based assays, effectively detect the risk for venous thrombosis independent of FVL. Pre-dilution in factor V depleted plasma is an effective way to directly assess the risk independent of FVIII levels.

Keywords

Venous thrombosis - activated protein C resistance - factor V Leiden - factor VIII
 

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