NYMC Faculty Publications

Antiphospholipid Syndrome Thrombotic and Vascular Complications

Author Type(s)

Student, Faculty

DOI

10.1097/CRD.0000000000000590

Journal Title

Cardiology in Review

First Page

139

Last Page

144

Document Type

Article

Publication Date

3-1-2025

Department

Medicine

Keywords

antiphospholipid syndrome, direct oral anticoagulants, pathophysiology of antiphospholipid syndrome, treatment of antiphospholipid syndrome

Disciplines

Medicine and Health Sciences

Abstract

Antiphospholipid syndrome is a rare, autoimmune thrombophilia defined by vascular thrombosis and pregnancy morbidity, in the setting of documented persistent antiphospholipid antibodies including the lupus anticoagulant, anticardiolipin antibodies, or anti-β2 glycoprotein I antibodies. The presence of antiphospholipid antibodies can be completely asymptomatic, or they can lead to clinical manifestations as severe as catastrophic antiphospholipid syndrome, which involves widespread coagulopathy over a very short period of time. The degree of risk associated with antiphospholipid syndrome depends on the characteristics of the antiphospholipid antibody profile and on the presence of additional thrombotic risk factors. The current standard treatment for unprovoked thrombosis is long-term warfarin. Treatment to prevent recurrent obstetric complications is low-dose aspirin and prophylactic heparin in pregnant patients. The use of direct oral anticoagulants in patients with antiphospholipid syndrome is still being debated. Their use is generally contraindicated, especially in high-risk patients, such as those with all 3 antiphospholipid antibodies present, but they may potentially be of some use in some low-risk patients.

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