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Venous thromboembolism is the third most common cause of vascular death after myocardial infarction and stroke, and is associated with considerable morbidity and premature mortality. The incidence of the most serious consequence of venous thromboembolism, fatal pulmonary embolism, ranges from 0.01% to 5% among hospitalised medical patients with multiple risk factors, and is currently considered the commonest avoidable cause of hospital death. Rivaroxaban is a small-molecule factor Xa inhibitor that belongs to a new class of direct oral anticoagulant agents that directly inhibit single enzymes in the coagulation pathway. Rivaroxaban has many advantages over vitamin K antagonists and unfractionated heparin and may become an alternative to traditional anticoagulant agents in patients at risk for thromboembolism. Moreover, antidotes exist and are in the progress of development, both specific and non-specific, for the treatment of overdose or side effects, including bleeding.
Background. A tendency to venous thromboembolism is otherwise called hypercoagulability or thrombophilia. This disease can be acquired or have a genetic background, and may lead to pulmonary embolism. The basis for analysis and selection of treatment is genetic diagnosis, which detects the G1691A mutation in the factor V gene (factor V Leiden) – the best known congenital thrombophilia marker. Material and methods. The study was carried out in the years 2015-2017 on samples taken from patients (462 men and 1284 women) with a tendency to venous thromboembolism. Real-Time PCR was used to detect G1691A mutation in factor V gene. The analyses were performed in the Hematology Laboratory of the Center of Laboratory Medicine at the Medical University of Gdańsk. Results. Significant differences in the frequency of Leiden mutation were shown. This mutation predominated in men (25%), while in women G1691A mutation was detected with a 15% frequency (p=0.04). All possible genotypes were found among the subjects and the percentage of heterozygotes and homozygotes in both genders was similar. Conclusions. Congenital t hrombophilia a ssociated w ith G1691A mutation of f actor V Leiden gene was found to be more common in men than in women. All possible genotypes were determined in the pool of test subjects. The mutation was most frequently detected in patients between 30 and 40 years of age, and rarely after 70 years of age.
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