The Effect of Genetically Related Risk Factors on the Recurrence Rate of Acute Pulmonary Embolism in a Tertiary Teaching Hospital in Jordan

Objectives: To identify the recurrence rate of Pulmonary Embolism (PE) during the first 6 months of the diagnosis of the patients while they were on anticoagulation therapy in order to study the impact of hereditary risk factors on the recurrence rate in patients with acute pulmonary embolism during the same period. Methods: A prospective study was conducted at Jordan University Hospital, from January 2005 to the end of December 2007. A follow up was conducted till July 2008. Ninety (90) patients with acute PE were investigated; only 72 patients were included in the study due to the loss of follow up of other patients. All patients were investigated for the genetically related thrombophilic factors (FVL, FII and MTHFR), plasma level of free protein C, protein S, and antithrombin III. The patients were divided into two groups: first group those who have recurrence of PE and the second group those who have no recurrence. Results: Seven patients (9.7%) out of 72 who met the inclusion criteria, had a recurrent episode of PE within the first 6 months of diagnosis. There was a significant correlation between the recurrence rate of PE and protein C deficiency p value 0.025. There was no significant correlation between the recurrence of PE and the rest of the hereditary thrombophilic factors. Conclusion: The results of our study necessitate the need to test patients with unprovoked vein thrombosis for the presence of deficiencies of natural anticoagulants; especially protein C level. Other potential risk factors for the recurrence of Venous Thromboembolism (VTE) have to be individualized. Further studies with a larger number of patients are needed to clarify the significance of these risk factors in the recurrence of PE.