Most common hereditary hypercoagulable state: 4-8% population
- Gene causes change in Factor V protein making it resistant to inactivation by protein C –> increased propensity to clot by increased Factor V concentrations in blood
- Long term homozygotes for Factor V Leiden will receive anticoagulation
- Must weigh risks of anticoagulation vs risk thrombosis
- Treatment length depends on circumstances of thrombosis
- High risk: Lifelong anticoagulation
- 2 or more spontaneous thrombosis or 1 spontaneous thrombosis in setting of AT3 deficiency or antiphospholipid syndrome
- 1 spontaneous thrombosis that is life threatening or at an unusual site
- 1 spontaneous thrombosis with >1 genetic defect predisposing to thromboembolic even
- Long term anticoagulation: those with inherited thrombophillia
- 3-6 months
- Maintain INR 2-3
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