Antiphospholipid syndrome secondary prevention: Difference between revisions

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Revision as of 20:25, 4 April 2018

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Feham Tariq, MD [2]

Overview

Secondary Prevention

Long term anticoagulation

Anticoagulation for venous thrombosis:

Anticoagulation for arterial thrombosis:

For patients having definite diagnosis of antiphospholipid syndrome (APS) and previous history of arterial thrombosis are treated with warfarin and low dose aspirin.

Reduction of reversible risk factors

During the perioperative period, this may include minimizing the period when patients are off anticoagulation, initiating early ambulation, and other measures to reduce venous stasis.

Continuation of anticoagulation:

For patients with APS and a history of an unprovoked thrombotic event, lifelong anticoagulation is recommended.

References

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@@ Line 10: / Line 10: @@
 '''Anticoagulation for arterial thrombosis''':
+For patients having definite diagnosis of antiphospholipid syndrome (APS) and previous history of arterial thrombosis are treated with warfarin and low dose aspirin.
 ===Reduction of reversible risk factors===
@@ Line 15: / Line 17: @@
 During the perioperative period, this may include minimizing the period when patients are off anticoagulation, initiating early ambulation, and other measures to reduce venous stasis.
+=== Continuation of anticoagulation: ===
+For patients with APS and a history of an unprovoked thrombotic event, lifelong anticoagulation is recommended.
-[[Randomized controlled trial]]s have addressed the secondary prevention of thromboses. These trials showed:
-* no benefit from high compared to low intensity warfarin<ref name="pmid 13679527">{{cite journal| author=Crowther MA, Ginsberg JS, Julian J, Denburg J, Hirsh J, Douketis J et al.| title=A comparison of two intensities of warfarin for the prevention of recurrent thrombosis in patients with the antiphospholipid antibody syndrome. | journal=N Engl J Med | year= 2003 | volume= 349 | issue= 12 | pages= 1133-8 | pmid=    13679527 | doi=10.1056/NEJMoa035241 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=13679527  }}  [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15122858 Review in: ACP J Club. 2004 Mar-Apr;140(2):38] </ref><ref name="pmid15869575">{{cite journal| author=Finazzi G, Marchioli R, Brancaccio V, Schinco P, Wisloff F, Musial J et al.| title=A randomized clinical trial of high-intensity warfarin vs. conventional antithrombotic therapy for the prevention of recurrent thrombosis in patients with the antiphospholipid syndrome (WAPS). | journal=J Thromb Haemost | year= 2005 | volume= 3 | issue= 5 | pages= 848-53 | pmid=15869575 | doi=10.1111/j.1538-7836.2005.01340.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15869575  }} </ref>
-A [[systematic review]] has summarized the research.<ref name="pmid18050167">{{cite journal| author=Ruiz-Irastorza G, Hunt BJ, Khamashta MA| title=A systematic review of secondary thromboprophylaxis in patients with antiphospholipid antibodies. | journal=Arthritis Rheum | year= 2007 | volume= 57 | issue= 8 | pages= 1487-95 | pmid=18050167 | doi=10.1002/art.23109 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18050167  }} </ref>
 ==References==