Thrombophilia primary prevention: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Thrombophilia}} | {{Thrombophilia}} | ||
{{CMG}} {{AE}} {{asiri}} | {{CMG}}; {{AE}} {{asiri}} {{JK}} | ||
==Overview== | ==Overview== | ||
[[Thrombophilia_medical_therapy| | [[Thrombophilia_medical_therapy|Thromboprophylaxis]] with [[anticoagulation]] may be recommended for primary prevention of acute thrombosis in high risk acquired and inherited thrombophilias.<ref name=?>DeLoughery TG. Hemostasis and Thrombosis: Springer International Publishing; 2014.</ref><ref name="pmid24421360">{{cite journal| author=Cohoon KP, Heit JA| title=Inherited and secondary thrombophilia. | journal=Circulation | year= 2014 | volume= 129 | issue= 2 | pages= 254-7 | pmid=24421360 | doi=10.1161/CIRCULATIONAHA.113.001943 | pmc=3979345 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24421360 }} </ref><ref name="pmid11309638">{{cite journal| author=Seligsohn U, Lubetsky A| title=Genetic susceptibility to venous thrombosis. | journal=N Engl J Med | year= 2001 | volume= 344 | issue= 16 | pages= 1222-31 | pmid=11309638 | doi=10.1056/NEJM200104193441607 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11309638 }} </ref><ref name="pmid22315265">{{cite journal| author=Falck-Ytter Y, Francis CW, Johanson NA, Curley C, Dahl OE, Schulman S et al.| title=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. | journal=Chest | year= 2012 | volume= 141 | issue= 2 Suppl | pages= e278S-325S | pmid=22315265 | doi=10.1378/chest.11-2404 | pmc=3278063 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22315265 }} </ref><ref name="pmid11919306">{{cite journal| author=Bergqvist D, Agnelli G, Cohen AT, Eldor A, Nilsson PE, Le Moigne-Amrani A et al.| title=Duration of prophylaxis against venous thromboembolism with enoxaparin after surgery for cancer. | journal=N Engl J Med | year= 2002 | volume= 346 | issue= 13 | pages= 975-80 | pmid=11919306 | doi=10.1056/NEJMoa012385 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11919306 }} </ref><ref name="pmid15598646">{{cite journal| author=Agnelli G| title=Prevention of venous thromboembolism in surgical patients. | journal=Circulation | year= 2004 | volume= 110 | issue= 24 Suppl 1 | pages= IV4-12 | pmid=15598646 | doi=10.1161/01.CIR.0000150639.98514.6c | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15598646 }} </ref> | ||
==Primary Prevention== | ==Primary Prevention== | ||
*'''Thrombosis Prevention:''' | |||
**There is no evidence to support the long-term pharmacological primary thromboprophylaxis of asymptomatic family members found to have a thrombophilic genotype. | |||
**Additionally, patients who experience a thrombotic event towards the end of their period of anticoagulant treatment course should be counseled about the signs and symptoms of thromboembolism and made aware about the requirement to seek an early medical attention on suspicion of a recurrence. | |||
**Moreover, they should be advised to mention their history of VTE to their physicians so that appropriate decisions about short-term thromboprophylaxis at times of increased thrombotic risk can be made. | |||
**Hence, all patients with a past history of VTE with or without evidence of a thrombophilic defect merit consideration for short-term thromboprophylaxis to cover periods of increased thrombotic risk such as surgery, trauma, plaster casts or immobilization. | |||
{| class="wikitable" | |||
|'''Table 1: Enlist the indications for thromboprophylaxis with [[anticoagulation]]'''<ref name=?>DeLoughery TG. Hemostasis and Thrombosis: Springer International Publishing; 2014.</ref><ref name="pmid24421360">{{cite journal| author=Cohoon KP, Heit JA| title=Inherited and secondary thrombophilia. | journal=Circulation | year= 2014 | volume= 129 | issue= 2 | pages= 254-7 | pmid=24421360 | doi=10.1161/CIRCULATIONAHA.113.001943 | pmc=3979345 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24421360 }} </ref><ref name="pmid11309638">{{cite journal| author=Seligsohn U, Lubetsky A| title=Genetic susceptibility to venous thrombosis. | journal=N Engl J Med | year= 2001 | volume= 344 | issue= 16 | pages= 1222-31 | pmid=11309638 | doi=10.1056/NEJM200104193441607 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11309638 }} </ref><ref name="pmid22315265">{{cite journal| author=Falck-Ytter Y, Francis CW, Johanson NA, Curley C, Dahl OE, Schulman S et al.| title=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. | journal=Chest | year= 2012 | volume= 141 | issue= 2 Suppl | pages= e278S-325S | pmid=22315265 | doi=10.1378/chest.11-2404 | pmc=3278063 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22315265 }} </ref><ref name="pmid11919306">{{cite journal| author=Bergqvist D, Agnelli G, Cohen AT, Eldor A, Nilsson PE, Le Moigne-Amrani A et al.| title=Duration of prophylaxis against venous thromboembolism with enoxaparin after surgery for cancer. | journal=N Engl J Med | year= 2002 | volume= 346 | issue= 13 | pages= 975-80 | pmid=11919306 | doi=10.1056/NEJMoa012385 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11919306 }} </ref><ref name="pmid15598646">{{cite journal| author=Agnelli G| title=Prevention of venous thromboembolism in surgical patients. | journal=Circulation | year= 2004 | volume= 110 | issue= 24 Suppl 1 | pages= IV4-12 | pmid=15598646 | doi=10.1161/01.CIR.0000150639.98514.6c | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15598646 }} </ref> | |||
|- | |||
! Indications for thromboprophylaxis | |||
|- | |||
| | |||
*[[Antithrombin]] deficiency | |||
*[[Zygosity|Homozygous or compound heterozygous]] mutations for the underlying thrombophilias | |||
*Multiple inherited thrombophilias | |||
*Family history of [[thrombosis]] at a young age | |||
*Post [[Orthopedic_surgery|orthopedic surgery]] | |||
*Post abdominal or pelvic surgery for gynecologic malignancies | |||
|} | |||
==References== | ==References== | ||
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[[Category:Hematology]] | [[Category:Hematology]] | ||
[[Category:FinalQCRequired]] | |||
{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
Latest revision as of 18:09, 10 March 2021
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Thrombophilia primary prevention On the Web |
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Risk calculators and risk factors for Thrombophilia primary 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
Thromboprophylaxis with anticoagulation may be recommended for primary prevention of acute thrombosis in high risk acquired and inherited thrombophilias.[1][2][3][4][5][6]
Primary Prevention
- Thrombosis Prevention:
- There is no evidence to support the long-term pharmacological primary thromboprophylaxis of asymptomatic family members found to have a thrombophilic genotype.
- Additionally, patients who experience a thrombotic event towards the end of their period of anticoagulant treatment course should be counseled about the signs and symptoms of thromboembolism and made aware about the requirement to seek an early medical attention on suspicion of a recurrence.
- Moreover, they should be advised to mention their history of VTE to their physicians so that appropriate decisions about short-term thromboprophylaxis at times of increased thrombotic risk can be made.
- Hence, all patients with a past history of VTE with or without evidence of a thrombophilic defect merit consideration for short-term thromboprophylaxis to cover periods of increased thrombotic risk such as surgery, trauma, plaster casts or immobilization.
| Table 1: Enlist the indications for thromboprophylaxis with anticoagulation[1][2][3][4][5][6] |
| Indications for thromboprophylaxis |
|---|
|
References
- ↑ 1.0 1.1 DeLoughery TG. Hemostasis and Thrombosis: Springer International Publishing; 2014.
- ↑ 2.0 2.1 Cohoon KP, Heit JA (2014). "Inherited and secondary thrombophilia". Circulation. 129 (2): 254–7. doi:10.1161/CIRCULATIONAHA.113.001943. PMC 3979345. PMID 24421360.
- ↑ 3.0 3.1 Seligsohn U, Lubetsky A (2001). "Genetic susceptibility to venous thrombosis". N Engl J Med. 344 (16): 1222–31. doi:10.1056/NEJM200104193441607. PMID 11309638.
- ↑ 4.0 4.1 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.
- ↑ 5.0 5.1 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.
- ↑ 6.0 6.1 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.