Vitamin K Antagonist Anticoagulation in Antiphospholipid Syndrome: Time in Therapeutic and Clinical Outcomes

被引：0

作者：

Meir, Keren ^{[1
]}

Niznik, Stanley ^{[1
,2
]}

Avnery, Orly ^{[1
,3
]}

Zoref-Lorenz, Adi ^{[1
,3
]}

Agmon-Levin, Nancy ^{[1
,2
]}

Ellis, Martin H. ^{[1
,3
]}

机构：

[1] Tel Aviv Univ, Fac Med & Hlth Sci, Sch Med, Tel Aviv, Israel

[2] Sheba Med Ctr, Angioedema & Allergy Inst, Zabludowicz Ctr Autoimmune Dis, Clin Immunol, Tel Hashomer, Israel

[3] Hematol Inst & Blood Bank, Meir Med Ctr, 59 Tchernichovsky St, IL-44281 Kefar Sava, Israel

来源：

AMERICAN JOURNAL OF MEDICINE | 2025年 / 138卷 / 02期

关键词：

Antiphospholipid syndrome; International normalized range; Thrombotic events; Time in therapeutic range; Vitamin K antagonists; WARFARIN; RIVAROXABAN; DISEASE; MANIFESTATIONS;

D O I：

10.1016/j.amjmed.2024.09.019

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

BACKGROUND: Thrombosis in antiphospholipid syndrome is still frequently treated with vitamin K antagonists, with a target international normalized ratio of 2-3. Time in therapeutic range of international normalized ratio of >= 70% is considered optimal. Time in therapeutic range among antiphospholipid syndrome patients is not well documented and the clinical consequences of poor international normalized ratio control are uncertain. This study aimed to determine the proportion of vitamin K antagonist-treated antiphospholipid syndrome patients achieving time in therapeutic range >= 70%, to define the features associated with poor control and to determine its association with thrombotic and bleeding events. METHODS: This medical records review included antiphospholipid syndrome patients treated with vitamin K antagonists, between 2012-2023. The proportion of patients achieving a time in therapeutic range >= 70% was determined, and thrombotic and bleeding events were compared between patients with time in therapeutic range >= 70% vs < 70%.<br /> RESULTS: Sixty seven antiphospholipid syndrome patients were studied. It was observed that 29.9% achieved time in therapeutic range >= 70% and 9.1% of patients with 3 or more comorbidities achieved time in therapeutic range values >= 70% compared with 40% of patients with less than 3 comorbidities. Fewer recurrent arterial and overall thrombotic events occurred with time in therapeutic range >= 70%. CONCLUSIONS: A minority of antiphospholipid syndrome patients treated with vitamin K antagonists achieve optimal anticoagulation and are at risk for recurrent thrombotic events, particularly arterial. Presence of multiple comorbidities is associated with poor international normalized ratio control. Careful monitoring of this patient population is warranted.<br /> (c) 2024 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.

引用

页码：269 / 277

页数：9

共 29 条

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