What are the racial predilections of nonplatelet hemostatic disorders?

Updated: Oct 28, 2019
  • Author: Muhammad A Mir, MD, FACP; Chief Editor: Perumal Thiagarajan, MD  more...
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Answer

Miyata et al identified 54 people with protein C deficiency by screening approximately 26,800 Japanese patients. This represents an observed prevalence of 1 case per 500 patients. [50] These researchers also found that 34 patients with protein C deficiency had earlier onset of acute myocardial infarction and atherothrombotic cerebral infarction compared with healthy patients. Their study suggests that congenital protein C deficiency contributes to an earlier onset of arterial occlusive diseases in Japanese subjects.

A study by Suehisa and colleagues of 113 consecutive Japanese patients with DVT found that 32 (28.3%) were deficient in antithrombin III (1.77%), protein C (7.96%), and protein S (17.7%). In comparison, 10 of the 392 healthy Japanese subjects had protein S deficiency (n = 8, 2.02%) or protein C deficiency (n = 2, 0.5%). The frequency of protein C and S deficiencies in patients with DVT was 15.6 and 7.38 times the control population frequency, respectively, and this difference was statistically significant (P < 0.05). These data suggest that the Japanese population has a high frequency of protein C and S deficiencies. [51]

In Taiwan, Shen and colleagues noted that prothrombin G20210A and factor V Leiden mutations were not found in 113 thrombophilic Chinese patients. [52] Only protein C and S deficiencies were significantly associated with increased risk for the development of thrombosis, with an odds ratio (OR) of 10.6 and 6.7, respectively. These findings suggest that protein C and protein S deficiencies are the most important risk factors for thrombosis in venous thrombophilic patients of Chinese extraction. The true prevalence of these hereditary disorders is unknown because of the high variability of clinical presentation. [53]


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