Premium
Beta‐receptor blockade decreases elevated plasma levels of factor VIII:C in patients with deep vein thrombosis
Author(s) -
Hoppener M. R.,
Kraaijenhagen R. A.,
Hutten B. A.,
Büller H. R.,
Peters R. J. G.,
Levi M.
Publication year - 2004
Publication title -
journal of thrombosis and haemostasis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.947
H-Index - 178
eISSN - 1538-7836
pISSN - 1538-7933
DOI - 10.1111/j.1538-7836.2004.00851.x
Subject(s) - medicine , discontinuation , propranolol , deep vein , thrombosis , venous thrombosis , gastroenterology , cohort , blockade , endocrinology , receptor
Summary. Background : An elevated plasma level of factor VIII:C (FVIII:C) is a strong and dose‐dependent risk factor for venous thromboembolism (VTE). The cause of elevated FVIII:C in patients with thrombophilia is as yet unknown. FVIII:C increases significantly after infusion of epinephrine, vasopressin or physical exercise. The aim of the present study was to investigate whether beta‐receptor blockade will lower sustained elevated FVIII:C in patients with VTE. Methods and Results : Two cohorts of patients with documented deep vein thrombosis and an elevated FVIII:C (>175 IU dL −1 ) and healthy volunteers, were studied. One cohort was treated with the beta‐receptor blocker, whereas the other cohort served as non‐treatment controls. The patient treatment group and healthy volunteers were given 40 mg propranolol, thrice daily, for 14 days. The mean baseline level of FVIII:C was 220 IU dL −1 and 102 IU dL −1 in patients and healthy volunteers, respectively. After 2 weeks of propranolol a significant 23% reduction of FVIII:C (− 52 IU dL −1 ; 95%CI:[−65; −39]) compared with no change over time in the patient no‐ treatment group (−1.8 IU dL −1 ; 95%CI:[−34; 30]). After discontinuation of propranolol FVIII:C returned to its initial high level. In healthy volunteers propranolol had no effect on the plasma concentration of FVIII:C. Conclusion : This study demonstrates that in patients with VTE a sustained elevated FVIII:C concentration can be decreased with the use of propranolol. This observation may be of potential clinical relevance, since it has been shown that each increase of 10 IU dL −1 in FVIII:C concentration enhanced the risk of a recurrent VTE by 24%.