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Low vitamin B6 levels and the risk of recurrent venous thromboembolism

From Unità di Ematologia e Trombosi, Ospedale San Paolo, Dipartimento di Medicina, Chirurgia e Odontoiatria, Università di Milano, Milano, Italy (MC); Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria (GH, SE, PAK); Dipartimento di Medicina e Specialità Mediche, IRCCS Fondazione Ospedale Maggiore, Mangiagalli e Regina Elena, Università di Milano, Italy (RL, AL)

Correspondence: Marco Cattaneo, MD, Unità di Ematologia e Trombosi,Ospedale San Paolo, Università di Milano, Via di Rudinì 8, 20142 Milano, Italy. E-mail: marco.cattaneo{at}unimi.it

Low plasma vitamin B6, measured as pyridoxal-5’-phosphate (PLP), is associated with an increased risk of first venous thromboembolism (VTE). In a prospective cohort of 757 patients with first VTE we investigated the association of PLP levels with risk of recurrent VTE. After 4 years, the likelihood of VTE recurrence was 22.5% (95% CI 13.6–31.5%) among patients with PLP 23.3 nmol/L and 14.4% (11.5–17.4%) among those with PLP >23.3 nmol/L (p=0.01). Patients with PLP 23.3 nmol/L had 1.8-fold higher recurrence risk (1.01–3.14) than patients with PLP >23.3 nmol/L (adjusted for confounders including homocysteine). Therefore, low vitamin B6 is a risk factor of recurrent VTE.

Key words: deep vein thrombosis, risk factors, pulmonary embolism, homocysteine, vitamin B6.