CLINICAL ANALYSIS OF A PATIENT WITH ANTIPHOSPHOLIPID SYNDROME AND SUB-MASSIVE PULMONARY EMBOLISM
https://doi.org/10.21518/2307-1109-2018-1-76-87
Abstract
The article presents a clinical analysis of the patient with a newly developed unprovoked episode of venous thromboembolic events. It discusses the challenges in the diagnosis of pulmonary embolism, the need for thrombolytic therapy in patients with pulmonary arterial thromboembolism of medium risk. The guidelines for diagnosis of antiphospholipid syndrome in accordance with modern principles are provided. It also considers the issues of anticoagulant treatment.
About the Authors
E. N. Krivosheeva
A.L.Myasnikov Clinical Cardiology Institute of the National Medical Research Centre of Cardiology, Federal State Budget Organization of the Ministry of Health of the Russian Federation
Russian Federation
Moscow
Russian Federation
Moscow
A. L. Komarov
A.L.Myasnikov Clinical Cardiology Institute of the National Medical Research Centre of Cardiology, Federal State Budget Organization of the Ministry of Health of the Russian Federation
Russian Federation
Moscow
Russian Federation
Moscow
R. M. Shakhnovich
A.L.Myasnikov Clinical Cardiology Institute of the National Medical Research Centre of Cardiology, Federal State Budget Organization of the Ministry of Health of the Russian Federation
Russian Federation
Moscow
Russian Federation
Moscow
I. S. Fedotchenkov
A.L.Myasnikov Clinical Cardiology Institute of the National Medical Research Centre of Cardiology, Federal State Budget Organization of the Ministry of Health of the Russian Federation
Russian Federation
Moscow
Russian Federation
Moscow
E. Р. Panchenko
A.L.Myasnikov Clinical Cardiology Institute of the National Medical Research Centre of Cardiology, Federal State Budget Organization of the Ministry of Health of the Russian Federation
Russian Federation
Moscow
Russian Federation
Moscow
References
1. Cohen AT, Agnelli G, Anderson FA, Arcelus JI, Bergqvist D, Brecht JG, Greer IA, Heit JA, Hutchinson JL, Kakkar AK, Mottier D, Oger E, Samama MM, Spannagl M. Venous thromboembolism (VTE) in Europe. The number of VTE events and associated morbidity and mortality. Thromb Haemost, 2007, 98(4): 756-764.
2. Management of massive and submassive pulmonaryembolism, iliofemoral deep vein thrombosis, and chronic thromboembolic pulmonary hypertension.a scientific statement from the American Heart Association. Circulation, 2011, 123: 1788-1830.
3. Russian clinical guidelines for diagnosis, treatment and prevention of venous thromboembolic complications. Flebologiya, 2015, 4 (2).
4. Martinez C, Cohen AT, Bamber L, Rietbrock S. Epidemiology of first and recurrent venous thromboembolism: a population-based cohort study inpatients without active cancer. Thromb Haemost, 2014, 112(2): 255-263.
5. Heit JA. Predicting the risk of venous thromboembolism recurrence, Am J Hematol, 2012, 87(1): 63-S67.
6. 2014 ESC Guidelines on the diagnosis and management of acute pulmonary embolism. European Heart Journal. doi: 10.1093/eurheartj/ehu283.
7. Meyer G, Vicaut E, Danays T, Agnelli G, Becattini C, Beyer-Westendorf J, Bluhmki E, Bouvaist H, Brenner B, Couturaud F, Dellas C, Empen K, Franca A, Galie N, Geibel A, Goldhaber SZ, Jimenez D, Kozak M, Kupatt C, Kucher N, Lang IM, Lankeit M, Meneveau N, Pacouret G, Palazzini M, Petris A, Pruszczyk P, Rugolotto M, Salvi A, Schellong S, Sebbane M, Sobkowicz B, Stefanovic BS, Thiele H, Torbicki A, Verschuren F, Konstantinides SV. Fibrinolysis for patients with intermediate-risk pulmonary embolism. N Engl J Med, 2014, 370(15): 1402-1411.
8. Konstantinides S, Vicaut E, Danays T, Becattini C, Bertoletti L, Beyer-Westendorf J, Bouvaist H, Couturaud F, Dellas C, Duerschmied D, Empen K, Ferrari E, Galie N, Jimenez D, Kostrubiec M, Kozak M, Kupatt C, Lang IM, Lankeit M, Meneveau N, Palazzini M, Pruszczyk P, Rugolotto M, Salvi A, Sanchez O, Schellong S, Sobkowicz B, Meyer G. Impact of thrombolytic therapy on the long-term outcome of intermediate-risk pulmonary embolism, J Am Coll Cardiol, 2017, 69(12): 1536-1544.
9. Sharifi M, Bay C, Skrocki L, Rahimi F, Mehdipour M. Moderate pulmonary embolism treated with thrombolysis (from the «MOPETT»Trial). Am J Cardiol, 2013, 111: 273–277.
10. Wang C, Zhai Z, Yang Y, Wu Q, Cheng Z, Liang L, Dai H, Huang K, Lu W, Zhang Z, Cheng X, Shen YH, China Venous Thromboembolism (VTE) Study Group. Efficacy and safety of low dose recombinant tissue-type plasminogen activator for the treatment of acute pulmonary thromboembolism: a randomized, multicenter, controlled trial. Chest, 2010, 137: 254–262.
11. Gupta A., Johnson D.H., Nagalla S. Antiphospholipid Antibodies. JAMA, 2017, 318(10): 959-960.
12. Vorobyova NM, Ermolina OV, Balakhonova TV, Kirienko AI, Panchenko EP. The impact of prolonged enoxaparin therapy on the risk of recurrence of venous thromboembolic complications and recanalization of thrombosed veins. Aterotromboz, 215, 2: 39-50.
13. Kearon C, Akl EA, Comerota AJ, Prandoni P, Bounameaux H, Goldhaber SZ, Nelson ME, Wells PS, Gould MK, Dentali F, Crowther M, Kahn SR. Antithrombotic therapy for VTE disease: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest, 2012, 142(6): 1698-1704.
14. Stevens SM, Woller SC, Bauer KA, Kasthuri R, Cushman M, Streiff M, Lim W, Douketis JD. Guidance for the evaluation and treatment of hereditary and acquired thrombophilia. J Thromb Thrombolysis, 2016, 41(1): 154–164.
Review
For citations:
Krivosheeva E.N., Komarov A.L., Shakhnovich R.M., Fedotchenkov I.S., Panchenko E.Р. CLINICAL ANALYSIS OF A PATIENT WITH ANTIPHOSPHOLIPID SYNDROME AND SUB-MASSIVE PULMONARY EMBOLISM. Aterotromboz = Atherothrombosis. 2018;(1):76-87. (In Russ.) https://doi.org/10.21518/2307-1109-2018-1-76-87
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