Homocysteine as a Risk Factor for Deep Venous Thrombosis At Kenyatta N Hospital,Nairobi
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OBJECTIVE:To determine the aetiological role of Hyperhomocysteinemia in Deep Venous Thrombosis. STUDY DESIGN: Case Control Study STUDY SETTING: Tertiary National Referral Hospital; Kenyatta N Hospital. STUDY SUBJECTS: Cases: patients with a Compression Doppler Ultrasonography (CDU) index diagnosis of lower limb DVT; Controls: staff & out-patients with no clinical evidence or diagnostic suspicion of DVT. Main Outcome Measure: Odds ratio for Hyperhomocysteinemia Methods: Consecutive patients with a clinical suspicion of Index DVT underwent CDU by a single sonography, if positive were recruited with an equal number of matched controls.. Fasting plasma homocysteine levels were assayed, and level > 10umol/l was defined as Hyperhomocysteinemia (HH). Traditional DVT risk factors were evaluated and an Odds ratio for HH calculated. Results: Between September 2000 to March 2001 60 consecutive patients were screened and 57 recruited with 50 healthy hospital staff & 7 non DVT out patients as controls. Mean case age was 36.4 yrs 10.0 with of 18 to 63 yrs range. 94.7% were female and all native Africans. The most prevalent traditional risk factor was hormonal contraceptive use (33.4%); 14 patients (24.6%) had more than one risk factor. Mean case homocysteine levels was 13.2 4.9 mols/l and 11.1 3.49 mols/l. in controls. Odds Ratio for HH 1.58, (95% CI 0.068-3.65). Conclusions: DVT risk factors in our patient population is multifactorial and Hyperhomocysteinemia is associated with a 58% relative risk for DVT.