What causes hypercoagulable states?
What causes hypercoagulable states?
Hypercoagulable states are usually genetic (inherited) or acquired conditions. The genetic form of this disorder means a person is born with the tendency to form blood clots. Acquired conditions are usually a result of surgery, trauma, medications or a medical condition that increases the risk of hypercoagulable states.
Inherited hypercoagulable conditions include:
- Factor V Leiden (the most common)
- Prothrombin gene mutation
- Deficiencies of natural proteins that prevent clotting (such as antithrombin, protein C and protein S)
- Elevated levels of homocysteine
- Elevated levels of fibrinogen or dysfunctional fibrinogen (dysfibrinogenemia)
- Elevated levels of factor VIII (still being investigated as an inherited condition) and other factors including factor IX and XI
- Abnormal fibrinolytic system, including hypoplasminogenemia, dysplasminogenemia and elevation in levels of plasminogen activator inhibitor (PAI-1 )
Acquired hypercoagulable conditions include:
- Cancer
- Some medications used to treat cancer, such as tamoxifen, bevacizumab, thalidomide and lenalidomide
- Recent trauma or surgery
- Central venous catheter placement
- Obesity
- Pregnancy
- Supplemental estrogen use, including oral contraceptive pills (birth control pills)
- Hormone replacement therapy
- Prolonged bed rest or immobility
- Heart attack, congestive heart failure, stroke and other illnesses that lead to decreased activity
- Heparin-induced thrombocytopenia (decreased platelets in the blood due to heparin or low molecular weight heparin preparations)
- Lengthy airplane travel, also known as "economy class syndrome"
- Antiphospholipid antibody syndrome
- Previous history of deep vein thrombosis or pulmonary embolism
- Myeloproliferative disorders such as polycythemia vera or essential thrombocytosis
- Paroxysmal nocturnal hemoglobinuria
- Inflammatory bowel syndrome
- HIV/AIDS
- Nephrotic syndrome (too much protein in the urine)