Inherited factor XI deficiency confers no protection against acute myocardial infarction

Background and purpose: Factor XI (FXI) contributes to thrombin generation thereby affecting fibrin formation and to down regulation of fibrinolysis by activation of thrombin‐activatable fibrinolysis inhibitor (TAFI). The purpose of this study was to evaluate whether patients with severe FXI deficie...

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Published in:Journal of thrombosis and haemostasis 2003-04, Vol.1 (4), p.658-661
Main Authors: Salomon, O., Steinberg, D. M., Dardik, R., Rosenberg, N., Zivelin, A., Tamarin, I., Ravid, B., Berliner, S., Seligsohn, U.
Format: Article
Language:English
Subjects:
Adult
Age Distribution
Aged
Aged, 80 and over
Arteriosclerosis - epidemiology
Arteriosclerosis - genetics
factor XI
Factor XI Deficiency - epidemiology
Factor XI Deficiency - genetics
Family Health
Female
Genotype
Humans
Incidence
Israel - epidemiology
Male
Middle Aged
myocardial infarction
Myocardial Infarction - epidemiology
Myocardial Infarction - genetics
Platelet Membrane Glycoproteins - genetics
Polymorphism, Genetic
Risk Factors
Thrombophilia - epidemiology
Thrombophilia - genetics
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Summary:Background and purpose: Factor XI (FXI) contributes to thrombin generation thereby affecting fibrin formation and to down regulation of fibrinolysis by activation of thrombin‐activatable fibrinolysis inhibitor (TAFI). The purpose of this study was to evaluate whether patients with severe FXI deficiency are protected against acute myocardial infarction (AMI). Methods: The incidence of AMI in patients with severe FXI deficiency (FXI activity less than 15 U dL−1) whose age was 35 years or more was compared to the incidence of AMI in age and gender matched persons of the general population. Atherosclerotic risk factors were assessed in FXI deficient patients and blood was tested for prothrombotic parameters such as FV Leiden, prothrombin G20210A, lupus anticoagulant, and platelet membrane polymorphisms. The common mutations causing FXI deficiency in Jews were also examined. Results: Of 96 patients with severe FXI deficiency (55 women and 41 men) 16 had a history of AMI (6 women and 10 men). The median age at the time of AMI was 64.5 for women and 58 for men. The calculated annual rate of AMI in men was similar to the expected in the general Israeli population, whereas in women it was almost 2‐fold higher, but this difference did not reach statistical significance. One or more atherosclerotic risk factors were observed in 13 of 16 patients (81.3%) with AMI compared to 44 of 79 patients (55.7%) without AMI (P 
ISSN:1538-7933
1538-7836
1538-7836
DOI:10.1046/j.1538-7836.2003.00195.x