Antiphospholipid syndrome secondary prevention

Antiphospholipid syndrome Microchapters
Home
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Antiphospholipid syndrome from other Diseases
Epidemiology and Demographics
Risk Factors
Natural History, Complications and Prognosis
Diagnosis
Diagnostic criteria
History and Symptoms
Physical Examination
Laboratory Findings
Chest X Ray
CT
MRI
Echocardiography or Ultrasound
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Case Studies
Case #1
Antiphospholipid syndrome secondary prevention On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Antiphospholipid syndrome 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 Antiphospholipid syndrome secondary prevention
CDC on Antiphospholipid syndrome secondary prevention
Antiphospholipid syndrome secondary prevention in the news
Blogs on Antiphospholipid syndrome secondary prevention
Directions to Hospitals Treating Antiphospholipid syndrome
Risk calculators and risk factors for Antiphospholipid syndrome secondary prevention

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

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.

Recommendations for secondary prophylaxis in patients with antiphospholipid antibodies and thrombosis
Patients with definite antiphospholipid syndrome and first venous event	Indefinite anticoagulation to a target INR 2·0–3·0
Patients with definite antiphospholipid syndrome and arterial event	Indefinite anticoagulation to a target INR 3·0–4·0
Patients with definite antiphospholipid syndrome and recurrent events despite warfarin with a target intensity of 2·0–3·0	Indefinite anticoagulation to a target INR 3·0–4·0 or alternative therapies such as extended therapeutic dose low-molecular-weight heparin
Patients with venous thromboembolism with single positive or low-titre antiphospholipid antibodies	As usual per recommendations for deep vein thrombosis treatment
Patients with arterial thrombosis with single positive or low-titre antiphospholipid antibodies	As usual per recommendations for arterial thrombosis

Patients with definite antiphospholipid syndrome and first venous event* Patients with definite antiphospholipid syndrome and recurrent events despite warfarin with a target intensity of 2·0–3·0 Patients with arterial thrombosis with single positive or low-titre antiphospholipid antibodies Secondary prophylaxis Indefinite anticoagulation to a target INR 2·0–3·0 Indefinite anticoagulation to a target INR 3·0–4·0 or alternative therapies such as extended therapeutic dose low-molecular-weight heparin As per usual recommendations for arterial thrombosis Patients with definite antiphospholipid syndrome and arterial event* Indefinite anticoagulation to a target INR 3·0–4·0 or combined antithrombotic treatment Patients with venous thromboembolism with single positive or low-titre antiphospholipid antibodies As per usual recommendations for deep vein thrombosis treatment INR=international normalised ratio. *Less aggressive or long-lasting antithrombotic treatments might be appropriate in low-risk patients.