Prevalence and Geographical Variation of Prothrombin G20210A Mutation in Patients with Cerebral Vein Thrombosis: A Systematic Review and Meta-Analysis.

Joaquín V Gonzalez,Fernando J Vazquez,Esteban Gándara,Andrés G Barboza,Pablo Garcia De Frutos

doi:10.1371/journal.pone.0151607

Abstract

ObjectivesTo compare the prevalence of prothrombin G20210A in patients with objectively confirmed cerebral vein or cortical vein thrombosis against healthy controls, and evaluate geographical variations.DesignSystematic review and meta-analysis of case control studies.MethodsWe conducted a systematic review of electronic databases including MEDLINE and EMBASE. The main outcome was the prevalence of prothrombin G20210A in patients with objectively confirmed cerebral vein or cortical vein thrombosis; we also analyzed individual country variations in the prevalence. The random-effects model OR was used as the primary outcome measure.ResultsIn total 19 studies evaluated 868 cases of cerebral venous thrombosis and 3981 controls. Prothrombin G20210A was found in 103/868 of the patients with cerebral venous thrombosis and 105/3999 of the healthy controls [random effects pooled OR 5.838, 95% CI 3.96 to 8.58; I217.9%]. The prevalence of prothrombin G20210A was significantly elevated in Italian studies (OR 9.69), in Brazilian studies (OR 7.02), and in German studies (OR 3.77), but not in Iranian studies (OR 0.98).ConclusionProthrombin G20210A is significantly associated with cerebral venous thrombosis when compared to healthy controls, although this association is highly dependent on the country of origin.

Highlights

Cerebral venous thrombosis is rare thrombotic condition commonly associated with the presence of thrombophilia[1]
Prothrombin G20210A was found in 103/868 of the patients with cerebral venous thrombosis and 105/3999 of the healthy controls [random effects pooled odds ratio (OR) 5.838, 95% CI 3.96 to 8.58; I217.9%]
Prothrombin G20210A is significantly associated with cerebral venous thrombosis when compared to healthy controls, this association is highly dependent on the country of origin

Summary

Introduction

Cerebral venous thrombosis is rare thrombotic condition commonly associated with the presence of thrombophilia[1]. In patients with deep vein thrombosis or pulmonary embolism the prevalence of prothrombin G20210A is highly dependent on the country of origin or ethnicity [3,4,5,6,7] but this variation has not been evaluated in patients with cerebral venous thrombosis. To address this issue, we examined the prevalence and geographical variation of carriers of the prothrombin G20210A in patients with cerebral vein or cortical vein thrombosis. We conducted a systematic review of electronic databases including MEDLINE and EMBASE to assess the prevalence of Prothrombin G20210A in patients with cerebral vein thrombosis (S1 Text). The search was supplemented by hand-search of relevant articles, abstract books from international meetings and published reviews

Objectives

Results

Conclusion