Response to 'Re: Prothrombin G20210A Mutation and Lower Extremity Peripheral Arterial Disease. A Systematic Review and Meta-analysis'

VAZQUEZ, F.; GANDARA, E.

EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY : THE OFFICIAL JOURNAL OF THE EUROPEAN SOCIETY FOR VASCULAR SURGERY.

W B SAUNDERS CO LTD

Año: 2015 vol. 50 p. 827 - 828

1078-5884

We read with interest the letter by Boulon et al.1 The proposed association between prothrombin G20210A and thromboangiitis obliterans is very interesting. Prior studies have suggested that prothrombin G20210A interacts with other cardiovascular risk factors (especially smoking) to increase the risk of vascular events,2 and this interaction could further explain the association of prothrombin G20210A and thromboangiitis obliterans seen by Bérard et al. and Avcu et al.3, 4 The literature search conducted in our systematic review did not identify the study by Bérard et al.3, 5; had the study been included there would have been no changes in the association of lower extremity peripheral arterial disease (PAD) prothrombin G20210A (pooled random effect odds ratio 1.68 [95% confidence interval 0.94?3.00]; I2 52.1%; p = .08). Furthermore, the addition of the study by Bérard et al. does not modify the association between prothrombin G20210A and critical limb ischemia secondary to PAD (even in the absence of positive cases).3 Finally, we agree that well-designed prospective cohort studies are needed to evaluate the role of prothrombin G20210A in the progression and outcome of patients with PAD.