Armstrong Emily M, Bellone Jessica M, Hornsby Lori B, Treadway Sarah, Phillippe Haley M
Department of Pharmacy Practice, Auburn University Harrison School of Pharmacy, Auburn, AL, USA Department of Internal Medicine, University of South Alabama, Mobile, AL, USA
Department of Pharmacy Practice, Concordia University Wisconsin School of Pharmacy, Mequon, WI, USA.
J Pharm Pract. 2014 Jun;27(3):234-42. doi: 10.1177/0897190014530424. Epub 2014 Apr 17.
Acquired thrombophilia is associated with an increased risk of venous thromboembolism (VTE). Antiphospholipid syndrome (APS) is the most prevalent acquired thrombophilia and is associated with both venous and arterial thromboses. Human immunodeficiency virus (HIV) is another form of acquired thrombophilia. Risk factors associated with VTE in this population include those related to the disease itself, host factors, and the pharmacotherapy for HIV. A significant proportion of VTE events occur in patients with malignancies. There is an increase in mortality associated with patients having cancer who experience VTE when compared to patients having cancer without VTE. Combination oral contraceptive (COC) use infers risk of thromboembolic events. The risk is dependent upon the presence of an underlying inherited thrombophilia, the estrogen dose, and generation of progestin. Patients at highest risk of VTE include those receiving high-dose estrogen and fourth-generation, progesterone-containing contraceptives. With the exception of APS, thrombophilia status does not alter the acute treatment of an initial VTE in nonpregnant patients.
获得性血栓形成倾向与静脉血栓栓塞（VTE）风险增加相关。抗磷脂综合征（APS）是最常见的获得性血栓形成倾向，与静脉和动脉血栓形成均有关。人类免疫缺陷病毒（HIV）是获得性血栓形成倾向的另一种形式。该人群中与VTE相关的危险因素包括与疾病本身、宿主因素以及HIV药物治疗相关的因素。相当一部分VTE事件发生在恶性肿瘤患者中。与未发生VTE的癌症患者相比，发生VTE的癌症患者死亡率增加。使用复方口服避孕药（COC）会增加血栓栓塞事件的风险。风险取决于潜在的遗传性血栓形成倾向的存在、雌激素剂量以及孕激素的种类。VTE风险最高的患者包括接受高剂量雌激素和含第四代孕激素避孕药的患者。除APS外，血栓形成倾向状态不会改变非妊娠患者初始VTE的急性治疗。
