Thrombophilia primary prevention
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Asiri Ediriwickrema, M.D., M.H.S. [2]
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
Thromboprophylaxis with anticoagulation may be recommended for primary prevention of acute thrombosis in high risk acquired and inherited thrombophilias, which include:[1][2][3][4][5][6]
- Antithrombin deficiency
- Homozygous or compound heterozygous mutations for the underlying thrombophilias
- Multiple inherited thrombophilias
- Family history of thrombosis at a young age
- Post orthopedic surgery
- Post abdominal or pelvic surgery for gynecologic malignancies
- THROMBOSIS PREVENTION: There is no evidence to support a policy of long-term pharmacological primary thromboprophylaxis of asymptomatic family members found to have a thrombophilic genotype. The risk of serious or fatal haemorrhage considerably outweighs the risk of a fatal venous thrombotic event even for patients with the most severe types of thrombophilias, for example type I antithrombin deficiency or combinations of thrombophilic conditions. As patients who have had a thrombotic event come towards the end of their period of anticoagulant treatment, they should be counselled about the signs and symptoms of thromboembolism and should be aware of the requirement to seek medical attention early if they suspect a recurrence. They should also be advised that they should mention their history of venous thromboembolism to medical attendants so that appropriate decisions about short-term thromboprophylaxis at times of increased thrombotic risk can be made.
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.