Thrombophilia work-up and clinical outcomes in Indian patients with unprovoked venous and arterial thrombosis aged 18-50 years

Background: The prevalence of thrombophilia in patients with unprovoked thrombotic events varies across populations, justifying the need for region-specific data to guide appropriate testing strategies.Methods: This study included patients aged 18-50 years presenting with unprovoked venous thrombosis (VT), arterial thrombosis (AT), or combined thrombotic events at an Indian tertiary care center between January 2018 and January 2022. Clinical characteristics and results of the thrombophilia evaluation were analyzed.Results: A total of 226 patients were analyzed, of whom 160 (70.7%) had VT, 53 (23.4%) had AT, and 13 (5.7%) experienced combined thrombotic events. A positive thrombophilia work-up was observed in 33.2% of VT cases and 20.1% of AT cases. Antiphospholipid antibody syndrome (APS) was the most frequent abnormality detected, whereas inherited thrombophilia was less common. In VT patients, pulmonary involvement was significantly associated with positive thrombophilia results (p=0.04).Conclusions: These findings support a selective approach to thrombophilia testing in patients with unprovoked VT, in line with current guideline recommendations, and highlight APS as the predominant thrombophilic abnormality in this population.