Thrombophilia secondary prevention

Jump to navigation Jump to search

Thrombophilia Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Thrombophilia from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

X Ray

CT

MRI

Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Thrombophilia secondary prevention On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Thrombophilia secondary prevention

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Thrombophilia secondary prevention

CDC on Thrombophilia secondary prevention

Thrombophilia secondary prevention in the news

Blogs on Thrombophilia secondary prevention

Directions to Hospitals Treating Thrombophilia

Risk calculators and risk factors for Thrombophilia secondary prevention

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Asiri Ediriwickrema, M.D., M.H.S. [2] Jaspinder Kaur, MBBS[3]

Overview

Secondary prevention strategies following acute thrombosis in patients with thrombophilia include anticoagulation.

Secondary Prevention

  • Long-term therapy to prevent recurrence:
    • 90% risk reduction: The standard therapy for patients with DVT or PE typically includes anticoagulation with warfarin for 3– 12 months at a target INR between 2-3 after initial heparinization course.
    • Recurrences are less common after 6–12 months of discontinuation of anticoagulant therapy and when the initial event is associated with a transient risk factor such as surgery, trauma, etc.
Table 1: Enlist the indications for the secondary prevention[1][2][3][4][5][6][7]
Indications for secondary thromboprophylaxis
Table 2: Enlist the recommendations for indefinite anticoagulation at a target INR 2–3 [8]
High-risk conditions
  • Two or more spontaneous thromboses
  • One spontaneous thrombosis in the case of antithrombin deficiency or the antiphospholipid antibody syndrome
  • One spontaneous life-threatening thrombosis: Near-fatal PE; Cerebral, Mesenteric or Portal vein thrombosis
  • One spontaneous thrombosis at an unusual site: Mesenteric or Cerebral vein
  • One spontaneous thrombosis in the presence of more than a single genetic defect predisposing to a thromboembolic event

References

  1. Streiff MB, Agnelli G, Connors JM, Crowther M, Eichinger S, Lopes R; et al. (2016). "Guidance for the treatment of deep vein thrombosis and pulmonary embolism". J Thromb Thrombolysis. 41 (1): 32–67. doi:10.1007/s11239-015-1317-0. PMC 4715858. PMID 26780738.
  2. DeLoughery TG. Hemostasis and Thrombosis: Springer International Publishing; 2014.
  3. Cohoon KP, Heit JA (2014). "Inherited and secondary thrombophilia". Circulation. 129 (2): 254–7. doi:10.1161/CIRCULATIONAHA.113.001943. PMC 3979345. PMID 24421360.
  4. Seligsohn U, Lubetsky A (2001). "Genetic susceptibility to venous thrombosis". N Engl J Med. 344 (16): 1222–31. doi:10.1056/NEJM200104193441607. PMID 11309638.
  5. Falck-Ytter Y, Francis CW, Johanson NA, Curley C, Dahl OE, Schulman S; et al. (2012). "Prevention of VTE in orthopedic surgery patients: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines". Chest. 141 (2 Suppl): e278S–325S. doi:10.1378/chest.11-2404. PMC 3278063. PMID 22315265.
  6. Bergqvist D, Agnelli G, Cohen AT, Eldor A, Nilsson PE, Le Moigne-Amrani A; et al. (2002). "Duration of prophylaxis against venous thromboembolism with enoxaparin after surgery for cancer". N Engl J Med. 346 (13): 975–80. doi:10.1056/NEJMoa012385. PMID 11919306.
  7. Agnelli G (2004). "Prevention of venous thromboembolism in surgical patients". Circulation. 110 (24 Suppl 1): IV4–12. doi:10.1161/01.CIR.0000150639.98514.6c. PMID 15598646.
  8. Bauer KA (2001). "The thrombophilias: well-defined risk factors with uncertain therapeutic implications". Ann Intern Med. 135 (5): 367–73. doi:10.7326/0003-4819-135-5-200109040-00013. PMID 11529700.

Template:WH Template:WS