Abstract

Aim. To develop a model for calculating the risk of venous thrombosis, taking into account the presence of known risk factors, comorbidity and congenital thrombophilia. Material and methods . During the study (2015 to 2017), 79 patients with venous thrombosis were examined (36 men and 43 women, mean age — 56,76±15,570). The control group consisted of 83 patients and healthy volunteers without thrombosis at the moment and in history (35 men and 48 women, average age — 43,95±18,136). All individuals included in the study were analyzed for the presence of G1691A mutations in the factor V gene, G20210A in the prothrombin gene, C677T polymorphism in the 5,10-methylenetetrahydrofolate reductase gene, and polymorphism in the SERPINE1 gene of plasminogen activator inhibitor. Real-time polymerase chain reaction was used to identify mutations. To create a risk calculation model, a linear regression analysis was performed. Results. We have developed a model for calculating the risk of venous thrombosis. The resulting formula showed high prognostic accuracy (the area under the ROC curve is 95,9%). For patients who do not have data on the presence of these mutations, a short version of the risk calculation model was developed (the area under the ROC curve is 94,6%). Conclusion. We have developed a risk calculation model taking into account the presence of known risk factors, congenital thrombophilia and comorbidities. Thromboprophylaxis is necessary in >0,45 individual risk, which corresponds to a high risk of developing venous thrombosis. Patients who have not previously been diagnosed with thrombophilia and are in the middle risk group for venous thrombosis, according to a short version of the model, must be screened for congenital thrombophilia to clarify the risk.

Highlights

  • The control group consisted of 83 patients and healthy volunteers without thrombosis at the moment and in history (35 men and 48 women, average age — 43,95±18,136)

  • All individuals included in the study were analyzed for the presence of G1691A mutations in the factor V gene, G20210A in the prothrombin gene, C677T polymorphism in the 5,10-methylenetetrahydrofolate reductase gene, and polymorphism in the SERPINE1 gene of plasminogen activator inhibitor

  • We have developed a model for calculating the risk of venous thrombosis

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Summary

Модель расчета риска венозных тромбозов

Разработка модели расчета риска развития венозного тромбоза с учетом наличия известных факторов риска, сопутствующей патологии и врожденных тромбофилий. Нами была разработана модель расчета риска венозных тромбозов. У которых нет данных о наличии перечисленных мутаций, была разработана короткая версия модели расчета риска (площадь под ROC-кривой — 94,6%). Нами была разработана модель расчета риска с учетом наличия известных факторов, врожденных тромбофилий и сопутствующей патологии. М.н., доцент кафедры госпитальной терапии No 1 лечебного факультета, ORCID: 0000-0002-34966466, Герасимов А. М.н., профессор кафедры госпитальной терапии No 1 лечебного факультета, ORCID: 0000-0001-9935-2126, Хлевчук Т. М.н., доцент кафедры госпитальной терапии No 1 лечебного факультета, ORCID: 0000-0003-1453-7290, Кондратьева Т. М.н., доцент кафедры госпитальной терапии No 1 лечебного факультета, ORCID: 0000-00017938-1763, Аксенова М. М.н., доцент кафедры госпитальной терапии No 1 лечебного факультета, ORCID: 0000-0003-4802-6544, Патрушев Л. Кафедрой госпитальной терапии No 1 лечебного факультета, ORCID: 0000-0002-30146129. Рукопись получена 12.12.2018 Рецензия получена 04.02.2019 Принята к публикации 18.02.2019

Model for calculating the risk of venous thrombosis
Results
Ожирение I степени
Группы риска развития венозных тромбозов для версии МРР без учета тромбофилий
Чувствительность Чувствительность
Full Text
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