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Forum Name: Clots & Anticoagulants

Question: F V Leiden homozygous = warfarin 4 life?


 LauraL - Tue Oct 07, 2008 6:13 pm

I had my first DVT 2 months ago and have since been diagnosed Factor 5 Leiden homozygous. I'm currently on warfarin to treat the existing clot. Besides the genetic predisposition, and having been a long time smoker (I quit 2 weeks prior to getting the clot) I have no other apparent risk factors for clotting.
What is the current thinking on keeping someone like me on permanent warfarin therapy? Or maybe the question should be; does one clot in 44 years warrant a lifetime of anticoagulation?
I've read both pro and con online, but some of the information is pretty old. Both my PCP and hematologist will only say I'll be on warfarin "for a long time."

Your thoughts on the subject are appreciated!
 John Kenyon, CNA - Wed Oct 08, 2008 8:22 pm

User avatar Hello -

With either form of Factor V Leiden resulting in DVT, treatment is initially with lightweight heparin for about a week, followed by 3-6 months on warfarin. This may seem like "a long time" for a lot of people. Also, at the end of standard therapy, if there is still a high D-dimer result, this can result in extended warfarin therapy. Finally, if a subsequent DVT should occur, this is usually considered cause to make warfarin therapy lifelong. But on, one DVT in 44 years does not, in itself, warrant, as a rule, lifelong warfarin therapy. There are some additional risk factors that may be weighed and which may influence the duration of warfaring therapy, but these are all the standard risk factors for DVT in an otherwise healthy person.

In short, I would think your doctors' "for a long time" qualification probably was in consideration of an initial 3-6 month period, and possibly longer depending on post-therapy blood testing.

I hope this is helpful.
 LauraL - Thu Oct 09, 2008 11:45 am

I'm glad to hear you say that!
It's very helpful to have a point of discussion for my doc so we can put together a plan of action for the future. Even if "a long time" means a year, it's nice to have a glimmer of hope that it doesn't mean forever.
Thanks again for the info!
 John Kenyon, CNA - Thu Oct 09, 2008 7:56 pm

User avatar I'm glad you're glad, and I'm glad this gives you some of the info you'll need to make that long-term plan. Obviously there are no guarantees (on much of anything in life) but this should at least provide a starting point. Good luck to you and please do stay in touch.

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