Hypercoagulable States

Suspect in Pts with venous or arterial thrombosis at young age or unusual locations, recurrent thromboses or pregnancy loss, orFHx
Inherited Hypercoagulable States
Risk Factor Prevalence VTE Comments
Factor V Leiden 3–7% 4.3× Activated protein C (APC) resist.
Prothrombin mutation 2% 2.8× G20210A → ↑ prothrombin level
Hyperhomocysteinemia 5–10% 2.5× Inherited or acquired
Protein C deficiency 0.02–0.05% 11× Warfarin-induced skin necrosis risk
Protein S deficiency 0.01–1% 32×
Antithrombin III def. 0.04% 17.5× May be heparin resistant
Vascular Beds Affected by Inherited and Acquired Hypercoagulable States
Venous Venous and Arterial