Would you start anticoagulation in a patient with a history of CVA 1 year ago and high risk APL profile who was never started on anticoagulation, but is now presenting for follow up and without recurrent thrombotic events?

Topics: Rheumatology • Hematology • Antiphospholipid Syndrome • Benign Hematology • Neurology • Vascular Neurology

The patient has no known history of autoimmune disease.

Answer from: at Academic Institution

This is a difficult question. The details here are important. Therapeutically, you can go either way in my opinion. Were the positive antiphospholipid antibodies checked again later? Did the patient have an infection when the APS labs were first done? Does the patient have diabetes or other CV risk ...

Comments

at UPMC
I agree, it is not a simple "do or don't", it's we...

Answer from: at Academic Institution

Yes, I would start anticoagulation in this patient.

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Medical Oncologist at Alvin & Lois Lapidus Cancer Institute Northwest Hospital
Would you initiate warfarin, or a single antiplate...

at Dignity Health Sacramento
DOAC

at University of Colorado, Climate & Health Dept
Only Coumadin. Xarelto and other DOACs has been re...

Answer from: at Academic Institution

Yes, anticoagulation is getting safer and is now worth it in this case.

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at Hospital Perea
Agree with anticoagulation plus Plaquenil. This is...

Answer from: at Community Practice

Yes. Simply because it was not done previously is no reason to start now if warranted. And according to the history given it is warranted. Treat to prevent the (anticipated) next event.

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