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Reliable, easy-to-read patient information on common medical conditions ā€” written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.

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Thrombophilia secondary prevention

Introduction

Overview

Overview

Secondary prevention strategies following acute thrombosis in patients with thrombophilia include anticoagulation.

Secondary Prevention

Secondary Prevention

  • Long-term therapy to prevent recurrence:
    • 90% risk reduction: The standard therapy for patients with DVT or PE typically includes anticoagulation with warfarin for 3ā€“ 12 months at a target INR between 2-3 after initial heparinization course.
    • Recurrences are less common after 6ā€“12 months of discontinuation of anticoagulant therapy and when the initial event is associated with a transient risk factor such as surgery, trauma, etc.
Table 1: Enlist the indications for the secondary prevention[1][2][3][4][5][6][7]
Indications for secondary thromboprophylaxis
Table 2: Enlist the recommendations for indefinite anticoagulation at a target INR 2ā€“3 [8]
High-risk conditions
  • Two or more spontaneous thromboses
  • One spontaneous thrombosis in the case of antithrombin deficiency or the antiphospholipid antibody syndrome
  • One spontaneous life-threatening thrombosis: Near-fatal PE; Cerebral, Mesenteric or Portal vein thrombosis
  • One spontaneous thrombosis at an unusual site: Mesenteric or Cerebral vein
  • One spontaneous thrombosis in the presence of more than a single genetic defect predisposing to a thromboembolic event
References

References

  1. ā†‘ Streiff MB, Agnelli G, Connors JM, Crowther M, Eichinger S, Lopes R; et al. (2016). “Guidance for the treatment of deep vein thrombosis and pulmonary embolism”. J Thromb Thrombolysis. 41 (1): 32ā€“67. doi:10.1007/s11239-015-1317-0. PMCĀ 4715858. PMIDĀ 26780738.
  2. ā†‘ DeLoughery TG. Hemostasis and Thrombosis: Springer International Publishing; 2014.
  3. ā†‘ Cohoon KP, Heit JA (2014). “Inherited and secondary thrombophilia”. Circulation. 129 (2): 254ā€“7. doi:10.1161/CIRCULATIONAHA.113.001943. PMCĀ 3979345. PMIDĀ 24421360.
  4. ā†‘ Seligsohn U, Lubetsky A (2001). “Genetic susceptibility to venous thrombosis”. N Engl J Med. 344 (16): 1222ā€“31. doi:10.1056/NEJM200104193441607. PMIDĀ 11309638.
  5. ā†‘ 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): e278Sā€“325S. doi:10.1378/chest.11-2404. PMCĀ 3278063. PMIDĀ 22315265.
  6. ā†‘ 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): 975ā€“80. doi:10.1056/NEJMoa012385. PMIDĀ 11919306.
  7. ā†‘ Agnelli G (2004). “Prevention of venous thromboembolism in surgical patients”. Circulation. 110 (24 Suppl 1): IV4ā€“12. doi:10.1161/01.CIR.0000150639.98514.6c. PMIDĀ 15598646.
  8. ā†‘ Bauer KA (2001). “The thrombophilias: well-defined risk factors with uncertain therapeutic implications”. Ann Intern Med. 135 (5): 367ā€“73. doi:10.7326/0003-4819-135-5-200109040-00013. PMIDĀ 11529700.

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Asiri Ediriwickrema, M.D., M.H.S. [2] Jaspinder Kaur, MBBS[3]