1 Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
2 Cardiology Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Vasc Med. 2018 Aug;23(4):388-399. doi: 10.1177/1358863X18755927.
Evaluation for underlying hypercoagulable states in patients with thrombosis is a frequent clinical conundrum. Testing for thrombophilias is often reflexively performed without strategic approach nor clear appreciation of the clinical implications of such results. Guidelines vary in the appropriate utilization of thrombophilia testing. In this review, we discuss the more commonly encountered inherited and acquired thrombophilias, their association with initial and recurrent venous thromboembolism, arterial thromboembolism, and role in women's health. We suggest an approach to thrombophilia testing guided by the clinical presentation, suspected pathophysiology, and an understanding of how such results may affect patient care.
评估血栓形成患者潜在的高凝状态是临床上常见的难题。血栓形成倾向的检测通常是反射性的，而没有策略性的方法，也没有清楚地认识到这些结果的临床意义。指南在血栓形成倾向检测的适当应用方面存在差异。在这篇综述中，我们讨论了更常见的遗传性和获得性血栓形成倾向，它们与首发和复发性静脉血栓栓塞、动脉血栓栓塞的关系，以及在女性健康中的作用。我们建议根据临床表现、可疑的病理生理学以及对这些结果如何影响患者治疗的理解，来指导血栓形成倾向检测。
