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Antiphospholipid antibodies and the risk of recurrence after a first episode of venous thromboembolism: a systematic review

David Garcia, Elie A. Akl, Richard Carr and Clive Kearon

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  • RE: Discontinuation Of Anticoagulation In Antiphospholipid Syndrome Patients With Vascular Events
    • Yu Pei Chock, Physician Kent Memorial Hospital
    • Other Contributors:
      • Doruk Erkan, Rheumatologist

    We read with great interest the systematic review by Garcia et al., which concluded that ‘the quality of evidence pertaining to the risk of recurrent thrombosis among patients with an antiphospholipid antibodies (aPL) is very low and additional studies are needed to define the impact of aPL testing on clinical decision-making”.[1] Antiphospholipid Syndrome(APS) patients with vascular events generally receive life-long anticoagulation despite limited data on the optimal duration of anticoagulation. We would like to share our experience with long-term anticoagulation management of APS patients to help physicians decide the anticoagulation duration in APS patients.

    We performed a retrospective analysis on 11 patients identified from our registry, examining the clinical characteristics and outcomes of APS patients with vascular events who have discontinued warfarin. All patients (9 females, 8 Caucasians, mean age at time of event 34.9 ± 17.4 years) had history of single vascular events. Table 1 below outlines the characteristics, triggers, aPL profiles, hypercoagulable tests and duration the patients were on and off anticoagulation. After a thromboembolic event, the mean duration of anticoagulation was 25.4 ± 47.4 months. 10 patients were on warfarin, 1 patient was on low-molecular weight heparin. 7 (64%) patients were tested for D- dimer before anticoagulation was stopped. All 11 patients received low-dose aspirin after anticoagulation was stopped; there were no recur...

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    Conflict of Interest:
    None declared.