Predictors of thrombosis in relatives of patients with venous thromboembolism

Purpose of review Hereditary and acquired risk factors contribute to the development of venous thromboembolism (VTE). Relatives of patients who have a hereditary predisposition to thrombosis ('hereditary thrombophilia') will have a heightened risk of VTE if they share the same thrombophilic abnormality. However, if patients do not have a currently recognized thrombophilia it cannot be assumed that their relatives have a normal risk of thrombosis; the patient and their relatives may have a yet to be discovered hereditary abnormality. Recent findings A recent study by our group suggests that the relatives of patients with unprovoked VTE at a young age (e.g. < 45 years) have a substantially higher risk [odds ratio (OR) 3.3; 95% confidence interval (CI) 1.7-6.4] of developing VTE than the relatives of older patients with unprovoked VTE (e.g. > 71 years). This effect occurred independently of whether patients had a currently recognized hereditary thrombophilia. Summary Relatives of patients with unprovoked VTE have an increased risk of VTE. Testing for thrombophilia in the patients, and in the relatives of the patients who have a thrombophilia, allows the risk of thrombosis in the relatives to be estimated. Thrombosis at a young age appears to be an additional independent risk factor for a heightened risk of thrombosis in patients' relatives.