Antiphospholipid syndrome secondary prevention: Difference between revisions
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==Overview== | ==Overview== | ||
The secondary prevention of antiphospholipid syndrome includes reduction of reversible risk factors and life-long anticoagulation maintaining a target INR of 3.0-4.0 | The secondary prevention of antiphospholipid syndrome (APS) includes reduction of reversible risk factors and life-long anticoagulation maintaining a target INR of 3.0-4.0 | ||
==Secondary Prevention== | ==Secondary Prevention== | ||
===Reduction of reversible risk factors=== | ===Reduction of reversible risk factors=== | ||
The following risk factors should be controlled for the secondary prevention of APS: | |||
During the perioperative period, this may include minimizing the period when patients are off anticoagulation | * Oral contraceptives use | ||
* Smoking | |||
* Hypertension | |||
* Hyperlipidemia. | |||
* During the perioperative period, this may include minimizing the period when patients are off anticoagulation. | |||
* Initiating early ambulation | |||
* Measures to reduce venous stasis. | |||
=== Continuation of anticoagulation: === | === Continuation of anticoagulation: === | ||
Revision as of 00:45, 12 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 secondary prevention of antiphospholipid syndrome (APS) includes reduction of reversible risk factors and life-long anticoagulation maintaining a target INR of 3.0-4.0
Secondary Prevention
Reduction of reversible risk factors
The following risk factors should be controlled for the secondary prevention of APS:
- Oral contraceptives use
- Smoking
- Hypertension
- Hyperlipidemia.
- During the perioperative period, this may include minimizing the period when patients are off anticoagulation.
- Initiating early ambulation
- 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 |
*INR= International normalized ratio