Relationship Between Activated Protein C Resistance and Central Venous Device-Related Complications

• Published in: Clinical and applied thrombosis/hemostasis 1997-04, Vol.3 (2), p.133-136
• Main Authors: Keung, Yi-Kong, Cobos, Everardo, Barber, Annabel, Ronaghan, Cathy, Whitehead, Robert, Staton, Melody, Gilbert, Mary, Morgan, David
• Format: Article
• Language: English
• Subjects: Catheters; Proteins; Thrombosis
• ISSN: 1076-0296; 1938-2723
• DOI: 10.1177/107602969700300212

We studied the relationship between activated protein C (APC) resistance and the central venous devices (CVD)-related complications in 61 cancer patients (44 females `and 17 males, median age 50 years, 71 CVD) from November 1994 to November 1995. Two patients (3.3%) had APC resistance, i.e., APC ratio < 2. Twelve episodes of bactercmia, 8 site infections, 31 cases of CVD dysfunction requiring urokinase (UK), and 3 CVD-retated thromboses were noted. With Cox's proportional hazard models, low APC ratios and high d-dimer levels were significantly associated with CVD-related bacteremia (p = 0.0207 and 0.0210). Such an association was not observed with site infection and CVD dysfunction. The incidence of thrombosis was too low to be analyzed. However, one patient with APC resistance developed subclavian vein thrombosis, leading to eventual removal of the catheter. The prevalence of APC resistance in cancer patients and its association with bacteremia are discussed. Key Words : Activated protein C resistance—Central venous catheters—Bacteremia— Catheter site infection—Thrombosis.