TY - JOUR
T1 - Impact of inherited thrombophilia on venous thromboembolism in children
T2 - A systematic review and meta-analysis of observational studies
AU - Young, Guy
AU - Albisetti, Manuela
AU - Bonduel, Mariana
AU - Brandao, Leonardo
AU - Chan, Anthony
AU - Friedrichs, Frauke
AU - Goldenberg, Neil A.
AU - Grabowski, Eric
AU - Heller, Christine
AU - Journeycake, Janna
AU - Kenet, Gili
AU - Krümpel, Anne
AU - Kurnik, Karin
AU - Lubetsky, Aaron
AU - Male, Christoph
AU - Manco-Johnson, Marilyn
AU - Mathew, Prasad
AU - Monagle, Paul
AU - Van Ommen, Heleen
AU - Simioni, Paolo
AU - Svirin, Pavel
AU - Tormene, Daniela
AU - Nowak-Göttl, Ulrike
PY - 2008/9/23
Y1 - 2008/9/23
N2 - Background - The aim of the present study was to estimate the impact of inherited thrombophilia (IT) on the risk of venous thromboembolism (VTE) onset and recurrence in children by a meta-analysis of published observational studies. Methods and Results - A systematic search of electronic databases (Medline, EMBASE, OVID, Web of Science, The Cochrane Library) for studies published from 1970 to 2007 was conducted using key words in combination as both MeSH terms and text words. Citations were independently screened by 2 authors, and those meeting the inclusion criteria defined a priori were retained. Data on year of publication, study design, country of origin, number of patients/controls, ethnicity, VTE type, and frequency of recurrence were abstracted. Heterogeneity across studies was evaluated, and summary odds ratios and 95% CIs were calculated with both fixed-effects and random-effects models. Thirty-five of 50 studies met inclusion criteria. No significant heterogeneity was discerned across studies. Although >70% of patients had at least 1 clinical risk factor for VTE, a statistically significant association with VTE onset was demonstrated for each IT trait evaluated (and for combined IT traits), with summary odds ratios ranging from 2.63 (95% CI, 1.61 to 4.29) for the factor II variant to 9.44 (95% CI, 3.34 to 26.66) for antithrombin deficiency. Furthermore, a significant association with recurrent VTE was found for all IT traits except the factor V variant and elevated lipoprotein(a). Conclusions - The present meta-analysis indicates that detection of IT is clinically meaningful in children with, or at risk for, VTE and underscores the importance of pediatric thrombophilia screening programs.
AB - Background - The aim of the present study was to estimate the impact of inherited thrombophilia (IT) on the risk of venous thromboembolism (VTE) onset and recurrence in children by a meta-analysis of published observational studies. Methods and Results - A systematic search of electronic databases (Medline, EMBASE, OVID, Web of Science, The Cochrane Library) for studies published from 1970 to 2007 was conducted using key words in combination as both MeSH terms and text words. Citations were independently screened by 2 authors, and those meeting the inclusion criteria defined a priori were retained. Data on year of publication, study design, country of origin, number of patients/controls, ethnicity, VTE type, and frequency of recurrence were abstracted. Heterogeneity across studies was evaluated, and summary odds ratios and 95% CIs were calculated with both fixed-effects and random-effects models. Thirty-five of 50 studies met inclusion criteria. No significant heterogeneity was discerned across studies. Although >70% of patients had at least 1 clinical risk factor for VTE, a statistically significant association with VTE onset was demonstrated for each IT trait evaluated (and for combined IT traits), with summary odds ratios ranging from 2.63 (95% CI, 1.61 to 4.29) for the factor II variant to 9.44 (95% CI, 3.34 to 26.66) for antithrombin deficiency. Furthermore, a significant association with recurrent VTE was found for all IT traits except the factor V variant and elevated lipoprotein(a). Conclusions - The present meta-analysis indicates that detection of IT is clinically meaningful in children with, or at risk for, VTE and underscores the importance of pediatric thrombophilia screening programs.
KW - Meta-analysis
KW - Pediatrics
KW - Recurrence
KW - Thrombosis
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U2 - 10.1161/CIRCULATIONAHA.108.789008
DO - 10.1161/CIRCULATIONAHA.108.789008
M3 - Review article
C2 - 18779442
AN - SCOPUS:54049120183
SN - 0009-7322
VL - 118
SP - 1373
EP - 1382
JO - Circulation
JF - Circulation
IS - 13
ER -