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Factor V Leiden mutation is not associated with arterial events (stroke, ischemic stroke, MI)

  • 03

    By Adam Karalus, Physician Assistant Student at Daemen College and Contributor for Vein News and www.VeinsVeinsVeins.com

    It is well known that harboring Factor V Leiden mutations increases risk for developing venous thromboembolism events.  What is not known is whether Factor V leiden mutations cause arterial atherosclerotic events 

    Researchers from 71 institutions published the results of their study in Circulation.  The lead author of the study was Bakhtawar Mahmoodi from the St. Antonius Hospital, Department of Cardiology, Nieuwegein, the Netherlands and the Division of Hemostasis and Thrombosis, Department of Hematology, UMC Groningen, University of Groningen, The Netherlands. 

    A meta-analysis including 25 prospective studies (18 cohorts, 3 case-cohorts, 4 randomized trials) from the GENIUS-CHD (Genetics of Subsequent Coronary Heart Disease) consortium involving patients with established coronary heart disease (CHD) at baseline. The authors looked t primary outcomes and secondary outcomes for those with Factor V Leiden mutations.

    The primary outcome was composite of myocardial infarction and CHD death. Secondary outcomes included any stroke, ischemic stroke, coronary revascularization, cardiovascular mortality, and all-cause mortality.

    The studies included 69 681 individuals of whom 3190 (4.6%) were either heterozygous or homozygous (n=47) carriers of factor V Leiden. Median follow-up per study ranged from 1.0 to 10.6 years.

    The authors concluded that :

    1) Factor V Leiden was not associated with increased risk of subsequent atherothrombotic events and mortality in high-risk participants with established and treated coronary heart disease (CHD).

    2)  Routine assessment of factor V Leiden status is unlikely to improve atherothrombotic events risk stratification in this population of coronary heart disease. 

    Mahmoodi BK et cal.  Association of Factor V Leiden with subsequent atherosclerotic events: A Genius-CHD study of individual participant data.  Circulation 2020; 142(6): 546-555.