Chrysafi Maria, Casini Alessandro
Service d'angiologie et hémostase, HUG et Faculté de médecine, 1211 Genève 14.
Rev Med Suisse. 2018 Dec 5;14(630):2198-2201.
The thrombotic antiphospholipid syndrome is defined by persistent antiphospholipid antibodies and vascular thrombosis. Recommendations for the secondary thrombotic prevention in the thrombotic antiphospholipid syndrome are weak, based on a low-to-moderate quality of evidence. When the initial event leading to diagnosis is a venous thrombosis, the prevention of recurrence of a thrombotic event is based on anticoagulation with a vitamin K antagonist. When the initial event is an arterial thrombosis, the optimal antithrombotic regimen is more controversial and the role of aspirin is debated. Recent data suggest not to use direct oral anticoagulant in the -setting of the thrombotic antiphospholipid syndrome. The identification of patients with low risk of thrombotic recurrence could help in tailoring antithrombotic therapy.
血栓形成性抗磷脂综合征由持续性抗磷脂抗体和血管血栓形成所定义。基于低至中等质量的证据，关于血栓形成性抗磷脂综合征二级血栓形成预防的建议并不充分。当导致诊断的初始事件为静脉血栓形成时，血栓形成事件复发的预防基于使用维生素K拮抗剂进行抗凝治疗。当初始事件为动脉血栓形成时，最佳抗血栓治疗方案更具争议性，阿司匹林的作用也存在争议。近期数据表明，在血栓形成性抗磷脂综合征的情况下不建议使用直接口服抗凝剂。识别血栓形成复发低风险患者有助于制定个性化的抗血栓治疗方案。
