Factor V Leiden and prothrombin G20210A in relation to arterial and/or vein rethrombosis: Two cases

The factor V Leiden (FV Leiden) and prothrombin G20210A mutations, are the most common established genetic risk factors for deep vein thrombosis (DVT) . However, the relationship between these mutations and arterial thrombotic syndromes (coronary heart disease, myocardial infarction, stroke) has not been established. Some studies have suggested a relationship between them, but other authors have considered it unlikely that these anomalies are a ma jor risk factor for arterial thrombosis. From the clinical point of view, a question arises concerning the risk of repeated thrombosis in patients car rying one of these two mutations. The question is whether the recurrence is attributable to the mutations or to the presence of additional circumstant ial risk factors. As the risk of repeated thrombosis varies considerably fr om one patient to another, decisions about long-term treatment require weig hing the persistence of risk factors for vascular disease (venous and arter ial), especially in selected cases such. as young patients or patients with thrombosis of unusual localization.