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__NOTOC__ | __NOTOC__ | ||
{{Antiphospholipid syndrome}} | {{Antiphospholipid syndrome}} | ||
{{CMG}} {{AE}}{{FT}} | {{CMG}}; {{AE}}{{FT}} | ||
==Overview== | ==Overview== | ||
The primary prevention of antiphospholipid syndrome is anticoagulation with low-dose [[aspirin]] or [[warfarin]] in patients with risk factors for arterial and venous thrombosis, daily low dose of [[aspirin]] for primary thrombosis prevention in asymptomatic individuals with persistent antiphospholipid antibodies, minimizing the contribution of reversible risk factors for recurrent thrombosis and use of statins in patients with hyperlipidemia. | |||
==Primary Prevention== | ==Primary Prevention== | ||
The primary prevention of antiphospholipid syndrome is as follows:<ref name="pmid24449256">{{cite journal| author=Nalli C, Andreoli L, Casu C, Tincani A| title=Management of recurrent thrombosis in antiphospholipid syndrome. | journal=Curr Rheumatol Rep | year= 2014 | volume= 16 | issue= 3 | pages= 405 | pmid=24449256 | doi=10.1007/s11926-013-0405-4 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24449256 }} </ref><ref name="pmid15507275">{{cite journal| author=Erkan D, Lockshin MD| title=How much warfarin is enough in APS related thrombosis? | journal=Thromb Res | year= 2004 | volume= 114 | issue= 5-6 | pages= 435-42 | pmid=15507275 | doi=10.1016/j.thromres.2004.06.010 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15507275 }} </ref><ref name="pmid7885428">{{cite journal| author=Khamashta MA, Cuadrado MJ, Mujic F, Taub NA, Hunt BJ, Hughes GR| title=The management of thrombosis in the antiphospholipid-antibody syndrome. | journal=N Engl J Med | year= 1995 | volume= 332 | issue= 15 | pages= 993-7 | pmid=7885428 | doi=10.1056/NEJM199504133321504 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7885428 }} </ref> | The primary prevention of antiphospholipid syndrome is as follows:<ref name="pmid24449256">{{cite journal| author=Nalli C, Andreoli L, Casu C, Tincani A| title=Management of recurrent thrombosis in antiphospholipid syndrome. | journal=Curr Rheumatol Rep | year= 2014 | volume= 16 | issue= 3 | pages= 405 | pmid=24449256 | doi=10.1007/s11926-013-0405-4 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24449256 }} </ref><ref name="pmid15507275">{{cite journal| author=Erkan D, Lockshin MD| title=How much warfarin is enough in APS related thrombosis? | journal=Thromb Res | year= 2004 | volume= 114 | issue= 5-6 | pages= 435-42 | pmid=15507275 | doi=10.1016/j.thromres.2004.06.010 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15507275 }} </ref><ref name="pmid7885428">{{cite journal| author=Khamashta MA, Cuadrado MJ, Mujic F, Taub NA, Hunt BJ, Hughes GR| title=The management of thrombosis in the antiphospholipid-antibody syndrome. | journal=N Engl J Med | year= 1995 | volume= 332 | issue= 15 | pages= 993-7 | pmid=7885428 | doi=10.1056/NEJM199504133321504 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7885428 }} </ref> | ||
* Anticoagulation in patients with risk factors for arterial and venous thrombosis. | * Anticoagulation with low-dose [[aspirin]] or [[warfarin]] in patients with risk factors for [[Artery|arterial]] and venous [[thrombosis]]. | ||
* Minimizing the contribution of reversible risk factors for recurrent thrombosis. | * Minimizing the contribution of reversible risk factors for recurrent thrombosis. | ||
* A daily low dose of aspirin for primary thrombosis prevention in asymptomatic individuals with persistent antiphospholipid antibodies. | * A daily low dose of [[aspirin]] for primary thrombosis prevention in asymptomatic individuals with persistent antiphospholipid antibodies. | ||
* Use of statins in patients with hyperlipidemia. | * Use of statins in patients with hyperlipidemia. | ||
{| class="wikitable" | {| class="wikitable" | ||
! colspan="2" |Primary thromboprophylaxis | ! colspan="2" align="center" style="background:#4479BA; color: #FFFFFF;colspan=" 2 " |Primary thromboprophylaxis | ||
|- | |||
!Condition | |||
!Comment | |||
|- | |- | ||
|Patients with systemic lupus erythematosus and lupus anticoagulant and/or persistently positive anticardiolipin | |Patients with systemic lupus erythematosus and lupus anticoagulant and/or persistently positive anticardiolipin | ||
|Hydroxychloroquine and consider low-dose aspirin | |[[Hydroxychloroquine]] and consider low-dose [[aspirin]] | ||
|- | |- | ||
|Patients with obstetric antiphospholipid syndrome | |Patients with obstetric antiphospholipid syndrome | ||
|Low-dose aspirin or no therapy | |Low-dose [[aspirin]] or no therapy | ||
|- | |- | ||
|Asymptomatic carriers of antiphospholipid antibodies | |Asymptomatic carriers of antiphospholipid antibodies | ||
|No therapy or low dose aspirin | |No therapy or low dose [[aspirin]] | ||
|- | |- | ||
|All patients with antiphospholipid antibodies | |All patients with antiphospholipid antibodies | ||
| Line 28: | Line 32: | ||
|Adequate thromboprophylaxis | |Adequate thromboprophylaxis | ||
|} | |} | ||
==References== | ==References== | ||
Latest revision as of 20:39, 24 April 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Feham Tariq, MD [2]
Overview
The primary prevention of antiphospholipid syndrome is anticoagulation with low-dose aspirin or warfarin in patients with risk factors for arterial and venous thrombosis, daily low dose of aspirin for primary thrombosis prevention in asymptomatic individuals with persistent antiphospholipid antibodies, minimizing the contribution of reversible risk factors for recurrent thrombosis and use of statins in patients with hyperlipidemia.
Primary Prevention
The primary prevention of antiphospholipid syndrome is as follows:[1][2][3]
- Anticoagulation with low-dose aspirin or warfarin in patients with risk factors for arterial and venous thrombosis.
- Minimizing the contribution of reversible risk factors for recurrent thrombosis.
- A daily low dose of aspirin for primary thrombosis prevention in asymptomatic individuals with persistent antiphospholipid antibodies.
- Use of statins in patients with hyperlipidemia.
| Primary thromboprophylaxis | |
|---|---|
| Condition | Comment |
| Patients with systemic lupus erythematosus and lupus anticoagulant and/or persistently positive anticardiolipin | Hydroxychloroquine and consider low-dose aspirin |
| Patients with obstetric antiphospholipid syndrome | Low-dose aspirin or no therapy |
| Asymptomatic carriers of antiphospholipid antibodies | No therapy or low dose aspirin |
| All patients with antiphospholipid antibodies | Strict control of vascular risk factors |
| High-risk situations (surgery, post partum, long-lasting immobilisation) | Adequate thromboprophylaxis |
References
- ↑ Nalli C, Andreoli L, Casu C, Tincani A (2014). "Management of recurrent thrombosis in antiphospholipid syndrome". Curr Rheumatol Rep. 16 (3): 405. doi:10.1007/s11926-013-0405-4. PMID 24449256.
- ↑ Erkan D, Lockshin MD (2004). "How much warfarin is enough in APS related thrombosis?". Thromb Res. 114 (5–6): 435–42. doi:10.1016/j.thromres.2004.06.010. PMID 15507275.
- ↑ Khamashta MA, Cuadrado MJ, Mujic F, Taub NA, Hunt BJ, Hughes GR (1995). "The management of thrombosis in the antiphospholipid-antibody syndrome". N Engl J Med. 332 (15): 993–7. doi:10.1056/NEJM199504133321504. PMID 7885428.