Acquired activated protein C resistance in postmenopausal women is dependent on factor VIII: c levels

Rossella Marcucci, Rosanna Abbate, Sandra Fedi, Anna Maria Gori, Tamara Brunelli, Vincenza Bruni, Sandra Bucciantini, Serena Micheli, Guglielmina Pepe, Domenico Prisco, Gian Franco Gensini

Research output: Contribution to journalArticlepeer-review


Activated protein C (APC) resistance is an established risk factor for venous thromboembolism. In 5% to 10% of patients with venous thromboembolism, the APC resistance phenotype is observed in the absence of factor V Leiden mutation. Moreover, some physiologic and pathologic conditions are associated with an 'acquired' APC resistance, not caused by the Leiden mutation, such as inflammatory diseases, pregnancy, or oral contraceptive therapy. Several studies have demonstrated the effect of menopause on the hemostatic system, but no data are available about APC resistance. We found a high prevalence of APC resistance in postmenopausal women, not associated with factor V Leiden mutation. The mechanism that underlies this acquired APC resistance may be related to the higher levels of factor VIII, which showed a strong inverse correlation with APC resistance, whereas no correlation was found between the normalized APC ratio, factor V levels, and protein S values. Higher levels of factor VIII correlated with a marker of coagulation activation, such as prothrombin fragments 1 plus 2. Therefore, to identify women receiving hormone replacement therapy who have a greater risk for deep venous thrombosis, the APC resistance coagulation test should be used instead of the genetic study.

Original languageEnglish
Pages (from-to)769-772
Number of pages4
JournalAmerican Journal of Clinical Pathology
Issue number6
Publication statusPublished - 1999


  • Activated protein C resistance
  • Factor VIII
  • Menopause

ASJC Scopus subject areas

  • Pathology and Forensic Medicine


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