Hypercoagulable States

Inherited Hypercoagulable States

  • Antithrombin III Deficiency (see Antithrombin III Deficiency)
  • Congenital Venous Anomalies
  • Dysfibrinogenemia (see Dysfibrinogenemia): rare -> may result in both venous and arterial thromboses
  • Elevated Factor VIII
  • Factor V Leiden (see Factor V Leiden)
    • Most common inherited hypercoagulable state in Caucasian populations
    • Diagnosis: abnormal activated protein C (APC) resistance assay
  • Factor XII Deficiency (see Factor XII Deficiency): rare
  • Heparin Co-Factor II Deficiency: rare
  • Homocystinuria: may result in both venous and arterial thromboses
  • Increased Factor VIII Coagulant Activity: rare
  • Plasminogen Deficiency: rare
  • Protein S Deficiency (see Protein S Deficiency)
  • Protein C Deficiency (see Protein C Deficiency)
  • Prothrombin G20210A Mutation
    • Diagnosis: abnormal activated protein C (APC) resistance assay

Acquired Hypercoagulable States

Hematologic

Neoplastic

  • Tissue Factor
  • Cancer Procoagulant: may result in both venous and arterial thromboses
    • Diagnosis: some cases manifest abnormal activated protein C (APC) resistance assay

Hormonal

  • Hormone Replacement Therapy: may result in both venous and arterial thromboses
    • Diagnosis: some cases manifest abnormal activated protein C (APC) resistance assay
  • Oral Contraceptives (OCP) (see Oral Contraceptives): may result in both venous and arterial thromboses
    • Diagnosis: some cases manifest abnormal activated protein C (APC) resistance assay
  • Pregnancy (see Pregnancy)
    • Diagnosis: some cases manifest abnormal activated protein C (APC) resistance assay
  • Tamoxifen (see Tamoxifen): may result in both venous and arterial thromboses

Other

  • Age: increasing age increases risk of thrombosis
  • Activated Protein C (APC) Resistance (Non-Genetic)
  • Bevacizumab (Avastin) (see Bevacizumab): 2-fold increased risk of thromboembolic disease (may be due to vascular injury)
  • Congestive Heart Failure (CHF) (see Congestive Heart Failure)
  • Inflammatory Bowel Disease (IBD)
  • Hospitalization
  • Immobilization
  • Infection
  • Nephrotic Syndrome (see Nephrotic Syndrome)
  • Obesity (see Obesity)
  • Prior Thrombosis: prior thrombosis increases the risk of thrombosis
  • Smoking (see Tobacco)
  • Surgery: especially orthopedic surgery
  • Trauma

Other/Mixed Hypercoagulable States


References

  • APC resistance: biological basis and acquired influences. J Thromb Haemost. 2010 Mar;8(3):445-53 [MEDLINE]