American Society of Hirudotherapy

Association between thrombophilic gene variants and thrombosis in the Iranian population: a systematic review and meta-analysis

Systematic review published in Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis (2025)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Meta-analysisClinical TrialsSafdari SM et al. · Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis, 2025

Abstract

Thrombophilia is influenced by genetic variants, such as Factor V Leiden (FVL) and the prothrombin G20210A mutation. In clinical settings, assessing numerous genetic factors can lead to diagnostic errors and unnecessary treatments. This meta-analysis examines gene variants associated with thrombosis in the Iranian population, where their role in thrombotic disorders remains underexplored. A systematic literature search was performed across PubMed, Scopus, and Web of Science, targeting case-control studies published up to July 2025. Studies were included if they evaluated thrombophilia-related polymorphisms in Iranian patients with various thrombotic conditions, such as recurrent pregnancy loss (RPL), venous thromboembolism (VTE), or deep vein thrombosis (DVT). Advanced statistical analyses, including random-effects models, fixed-effects models, and Bayesian meta-analysis, were used to compute odds ratios (ORs) and 95% confidence intervals (CIs). From 36 studies encompassing over 14 000 participants, significant associations emerged. For RPL, FVL G1691A heterozygote (OR: 1.998, 95% CI: 1.02-3.88), methylenetetrahydrofolate reductase (MTHFR) C677T heterozygote (OR: 1.77, 95% CI: 1.31-2.39), MTHFR A1298C heterozygote (OR: 3.10, 95% CI: 1.33-7.20) and homozygote (OR: 1.69, 95% CI: 1.05-2.70), prothrombin G20210A heterozygote (OR: 2.435, 95% CI: 1.09-5.39) and homozygote (OR: 0.487, 95% CI: 0.40-0.58), plasminogen activator inhibitor-1 (PAI-1) polymorphisms, factor V (FV) A4070G, FV 5279A/G, factor XIII (FXIII) Val34Leu, and integrin subunit beta-3 (ITGB3)1565T/C were linked to elevated RPL risk. Additionally, FVL G1691A heterozygote (OR: 5.25, 95% CI: 2.39-11.54) was associated with higher VTE risk, while MTHFR C677T heterozygote (OR: 1.404, 95% CI: 1.030-1.914) increased DVT risk. These ethnicity-specific findings highlight critical genetic risk factors for thrombotic disorders in Iranians, potentially guiding precise diagnostics and personalized interventions.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Publication typeJournal ArticleSystematic ReviewMeta-Analysis
Indexed MeSH termsHumansIranThrombophiliaFactor VThrombosisFemaleProthrombinMethylenetetrahydrofolate Reductase (NADPH2)Genetic Predisposition to DiseasePregnancy

Summary

Thrombophilia is influenced by genetic variants, such as Factor V Leiden (FVL) and the prothrombin G20210A mutation. In clinical settings, assessing numerous genetic factors can lead to diagnostic errors and unnecessary treatments.

Why This Matters for Hirudotherapy

This systematic review and meta-analysis of 36 case-control studies (over 14,000 participants) quantified how thrombophilic gene variants, Factor V Leiden, prothrombin G20210A, MTHFR, PAI-1 and others, associate with recurrent pregnancy loss, venous thromboembolism, and deep-vein thrombosis in the Iranian population, reporting elevated odds ratios for several variants. For ASH it is background on who carries inherited hypercoagulable risk, the patient context in which any antithrombotic strategy (pharmacologic or the leech's natural anticoagulant secretome) is considered. Honest caveat: this is genetic-epidemiology evidence summarizing other studies in one ethnic population, with high relevance to thrombosis risk-stratification but none to treatment; it says nothing about hirudotherapy, leeches, or any therapeutic intervention.

Citation

Association between thrombophilic gene variants and thrombosis in the Iranian population: a systematic review and meta-analysis.

Safdari SM et al. · Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis, 2025

Added to ASH library: May 28, 2026 · Site last updated: June 18, 2026

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