Thrombophilia in non‐thrombotic chronic venous disease of the lower limb – a systematic review

Summary Chronic venous disease (CVD) represents a significant healthcare burden. Thrombophilia is proposed as a risk factor, particularly for post‐thrombotic CVD. A systematic review was performed to determine the relationship between thrombophilia and non‐thrombotic CVD. MEDLINE® and Embase® databa...

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Bibliographic Details
Published in:British journal of haematology 2018-12, Vol.183 (5), p.703-716
Main Authors: Tan, Matthew K. H., Onida, Sarah, Laffan, Michael, Davies, Alun H.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Antibodies - blood
Antithrombins - metabolism
Blood Coagulation Factors - metabolism
Causation
Chronic Disease
Clinical trials
Female
Fibrinolysis - physiology
Hematology
Humans
Hyperhomocysteinemia - complications
Lower Extremity - blood supply
Lupus Coagulation Inhibitor - immunology
Male
Middle Aged
Mutation - genetics
Population studies
Prothrombin - genetics
Risk Factors
Systematic review
Thrombophilia
Thrombophilia - complications
varicose ulcer
Varicose Ulcer - etiology
varicose veins
Vascular Diseases - etiology
Veins
venous insufficiency
Young Adult
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Summary:Summary Chronic venous disease (CVD) represents a significant healthcare burden. Thrombophilia is proposed as a risk factor, particularly for post‐thrombotic CVD. A systematic review was performed to determine the relationship between thrombophilia and non‐thrombotic CVD. MEDLINE® and Embase® databases were searched from 1946 up to March 2018. Case‐control studies, cohort studies or randomised clinical trials reporting on thrombophilias in non‐thrombotic lower limb CVD in adult patients were included. Non‐English and post‐thrombotic syndrome studies were excluded. Study selection and data extraction were performed by two reviewers. Fifteen studies were included, reporting on 916 cases and 1261 controls. Studies largely focused on venous ulceration and investigated multiple haemostatic factors. An association between thrombophilia and non‐thrombotic CVD was identified, with greater prevalence and factor concentration alteration reported in patients compared to controls. Concomitant thrombophilia presence was associated with earlier CVD onset. Relationship strength varied, with commoner aetiologies showing clearer correlation than rarer ones. Thrombophilia is associated with non‐thrombotic CVD but the mechanism is unclear and causation cannot be determined. Future research should focus on prospective studies with larger populations and identify adjunct therapies targeting thrombophilia.
ISSN:0007-1048
1365-2141
DOI:10.1111/bjh.15692