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(Arteriosclerosis, Thrombosis, and Vascular Biology. 1999;19:1020-1025.)
© 1999 American Heart Association, Inc.

Original Contributions

Coagulation Factors II, V, VII, and X, Prothrombin Gene 20210GA Transition, and Factor V Leiden in Coronary Artery Disease

High Factor V Clotting Activity Is an Independent Risk Factor for Myocardial Infarction

M. Redondo; H. H. Watzke; B. Stucki; I. Sulzer; F. Demarmels Biasiutti; B. R. Binder; M. Furlan; B. Lämmle; W. A. Wuillemin

From the Central Hematology Laboratory, Inselspital, University Hospital Bern, Switzerland (M.R., B.S., I.S., F.D.B., M.F., B.L., W.A.W.); the Department of Hematology and Hemostaseology (H.H.W.), and the Department of Vascular Biology and Thrombosis Research (B.R.B.), University of Vienna, Austria.

Correspondence to Walter A. Wuillemin, MD, PhD, Central Hematology Laboratory, University Hospital, Inselspital, CH-3010 Bern, Switzerland. E-mail wwuillem{at}insel.ch

Abstract—Increased levels of hemostatic factors and genetic mutations of proteins involved in coagulation may play a role in the pathogenesis of coronary artery disease. We investigated clotting activity of factors II (FII:C), V (FV:C), VII (FVII:C), and X (FX:C), the prothrombin gene 20210GA transition, and the factor V Leiden mutation in 200 survivors of myocardial infarction and in 100 healthy controls. FV:C (P<0.0001) and FVII:C (P<0.0001) were found to be independent risk factors for myocardial infarction. High FV:C or high FVII:C combined with smoking or arterial hypertension increased the relative risk for myocardial infarction up to 50-fold. One of 177 patients (0.6%) and 4 of 89 controls (4.5%) had the prothrombin 20210 AG genotype. Eleven of 177 patients (6.2%) and 6 of 89 controls (6.7%) were heterozygous for the factor V Leiden mutation. No homozygous carrier for these mutations was found. Neither the prothrombin gene 20210GA transition (odds ratio [OR], 0.1; 95% confidence interval [CI], 0.01 to 1.1) nor the factor V Leiden mutation (OR, 1.0; 95% CI, 0.4 to 2.8) were associated with an increased relative risk for myocardial infarction. In conclusion, our data indicate that neither the prothrombin gene 20210GA transition nor the factor V Leiden mutation are risk factors for myocardial infarction. High FVII:C was confirmed to be an independent risk factor for myocardial infarction. Moreover, we describe for the first time that high FV:C is an independent risk factor for myocardial infarction.

Key Words: coagulation factor V • prothrombin gene • factor V Leiden • myocardial infarction

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