Combined effect of high factor VIII levels and high mean platelet volume on the risk of future incident venous thromboembolism.

BACKGROUND High factor VIII (FVIII) levels and large platelets, as reflected by a high mean platelet volume (MPV), are separately associated with increased risk of venous thromboembolism (VTE). Whether the combination of high FVIII and large platelets has supra-additive effect on VTE risk is unknown. OBJECTIVE We aimed to investigate the joint effect of high FVIII levels and large platelets, as reflected by high MPV, on the risk of future incident VTE. METHODS A population-based nested case-control study with 365 incident VTE cases and 710 controls was derived from the Tromsø Study. FVIII antigen levels and MPV were measured in blood samples drawn at baseline. Odds ratios (ORs) with 95% confidence intervals (CIs) were estimated across FVIII tertiles (<85%, 85-108%, ≥108%) and within predefined MPV strata (<8.5, 8.5-9.5, 9.5 fL). RESULTS The VTE risk increased linearly across FVIII tertiles (Ptrend<0.001) in models adjusted for age, sex, body mass index and C-reactive protein. In the combined analysis, participants with FVIII levels in the highest tertile and MPV≥9.5 fL (i.e., joint exposure) had an OR for VTE of 2.71 (95% CI 1.44-5.11) compared with those with FVIII in the lowest tertile and MPV<8.5 fL (reference). In the joint exposure group, 52% (95% CI 17-88%) of VTEs were attributable to the biological interaction between FVIII and MPV. CONCLUSION Our results suggest that large platelets, as reflected by high MPV, might play a role in the mechanism by which high FVIII increases the risk of incident VTE.

• Publication year

  2023

• Venue

  Journal of Thrombosis and Haemostasis

• Publication date

  2023-06-01

• Fields of study

  Medicine

• Identifiers
  DOI 10.1016/j.jtha.2023.06.022PMID 37393000
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

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