Darlow Jennifer, Mould Holly
Manchester Royal Infirmary, Manchester, UK
equal first authors.
Clin Med (Lond). 2021 Sep;21(5):e487-e491. doi: 10.7861/clinmed.2020-1008. Epub 2021 Sep 7.
Venous thromboembolism (VTE) is increasingly recognised in primary and secondary care practice. The arrival of direct oral anticoagulants (DOACs) has made the management of VTE easier and more convenient. Some patients established on DOACs may need screening for underlying thrombophilias as certain thrombophilic conditions are known to confer a higher thrombosis risk, although the guidelines for when and how to test for a thrombophilia, especially in a patient taking a DOAC, are unclear. This literature review aims to examine when thrombophilia screening should take place in a patient already taking a DOAC, the effect of DOACs on thrombophilia tests, and analyse whether DOACs are safe and effective in both inherited and acquired thrombophilias.
静脉血栓栓塞症(VTE)在初级和二级医疗实践中越来越受到重视。直接口服抗凝剂(DOACs)的出现使VTE的管理变得更加容易和便捷。一些正在使用DOACs进行治疗的患者可能需要筛查潜在的血栓形成倾向,因为已知某些血栓形成倾向状况会带来更高的血栓形成风险,尽管关于何时以及如何检测血栓形成倾向的指南并不明确,尤其是对于正在服用DOACs的患者。这篇文献综述旨在研究在已经服用DOACs的患者中何时应进行血栓形成倾向筛查、DOACs对血栓形成倾向检测的影响,并分析DOACs在遗传性和获得性血栓形成倾向中是否安全有效。