医学
抗磷脂综合征
羟基氯喹
血栓形成
无症状的
重症监护医学
抗血栓
冲程(发动机)
阿司匹林
拜瑞妥
疾病
内科学
华法林
心房颤动
机械工程
2019年冠状病毒病(COVID-19)
传染病(医学专业)
工程类
作者
D. Paredes,Daniel Martín‐Iglesias,Guillermo Ruiz‐Irastorza
标识
DOI:10.1016/j.medcli.2024.02.010
摘要
Thrombotic manifestations, mainly venous thromboembolism (VTE) and stroke, are the most common and potentially life-threatening presentations of antiphospholipid syndrome (APS). The management of APS requires the assessment of the antiphospholipid antibodies (aPL) profile, of concurrent systemic lupus erythematosus or other systemic autoimmune diseases and the presence of risk factors for cardiovascular disease and bleeding. Anticoagulation with vitamin K antagonists (VKA) remains the cornerstone of therapy for thrombotic APS. As platelets play a central role in APS, low-dose aspirin is the first option for primary thromboprophylaxis in asymptomatic aPL carriers, and also plays a role as combination therapy with VKAs in arterial thrombosis. Treatment with direct oral anticoagulants (DOACs) could be considered in certain low-risk situations, although they are not recommended in patients with arterial thrombosis or triple positive aPL. Adjuvant therapies such as hydroxychloroquine and statins may be useful in complex settings such as thrombotic recurrences or high risk of bleeding. In this article, we review the evidence and the recommendations of the guidelines for the treatment of APS, and provide a critical and practical approach of its management from our clinical perspective.
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