THE RELATIONSHIP BETWEEN DEEP VEIN THROMBOSIS AND PLASMINOGEN ACTIVATOR INHIBITOR-1 4G/5G GENE POLYMORPHISM

Abstract

Deep vein thrombosis (DVT), which occurs as a result of the development of thrombosis in the lower extremity deep venous system, is a major health problem worldwide. DVT and pulmonary embolism (PE) are considered as different variants of the same disease, both of which are called venous thromboembolism (VTE). Overexpression of plasminogen activator inhibitor-1 (PAI-1) has been reported to negatively affect the fibrinolytic system, thereby increasing the risk of thrombotic events. It has been reported that the 4G allele increases the risk of venous thrombosis, especially in patients with other genetic thrombophilic defects, since the 4G allele is associated with increased PAI-1 level. Our study includes 32 patients diagnosed with DVT and whose thrombophilic risk factors were investigated. PAI-1 polymorphisms, factor V Leiden (FVL), prothrombin gene (PT G20210A), methylenetetrahydrofolate reductase (MTHR) C677T and A1298C were investigated in all patients. Eighteen of our patients are male and 14 are female; their ages ranged from 15 to 89 years and the mean age was 46.61 ± 20.14 years. Homozygous 4G/4G variant was detected in 9 (28.12%) patients and heterozygous 4G/5G variant in 21 (656%). PT G20210A was detected in 2 (6.2 %%) patients, FVL in 9 (28.1%), MTHFR C677T in 13 (40.6%) and MTHFR A1298C in 24 (75%). Four of nine patients carrying homozygous 4G/4G alleles were also FVL carriers. Although a relationship between PAI-1 and VTE has not been fully explained, clinical studies have shown that PAI-1 polymorphism may have a tendency against the development of VTE, especially in those carrying the FVL or PT G20210A polymorphism. Although the relationship between PAI-1 and VTE has not been fully explained, it is likely that PAI-1 polymorphism may increase the risk of DVT, especially in those who carry the FVL or PT G20210A polymorphism.