Table 2.
Features and treatment of patients with recurrent thrombotic or obstetric events
Pt | Age first event (years) | APS type | Triple + aPL | First event | Initial treatment | Time to recurrence (months) | Recurrent event | AC prescribed at time of recurrence | Adherence to AC treatment |
---|---|---|---|---|---|---|---|---|---|
5 | 14 | 2°, Thr | Yes | Splenic infarctiona | LDA | 7.6 | Renal TMAb | LDA | Yes |
8 | 17 | 2°, Thr | Yes | Myocardial infarctionb | Fondaparinux and LDA | 80.5 | Cardiac thrombusd | LDA; apixaban recently discontinued | Yes |
11 | 16 | 1°, Thr | Yes | PE, lower extremity DVTc | Warfarin | 59.0 | Lower extremity DVTc | Warfarin | No (loss of health insurance) |
13 | 16 | 2°, Thr | No | Lower extremity DVTc | Warfarin (planned for 3 months) | 19.4 | Lower extremity DVTd | None | - |
62.1 | Lower extremity DVTd | Rivaroxaban | No (patient reported) | ||||||
14 | 18 | 2°, Obs | No | HELLP, Pre-eclampsia, thrombotic vasculopathy of placenta and skind | LMWH – prophylactic dose | 4.6 | Early pregnancy lossd | LMWH – prophylactic dose | Yes |
16 | 10 | 2°, Thr | No | CVA, renal infarctiond | LMWH | 23.4 | CVAd | LMWH | No (physician reported) |
18 | 12 | 1°, Thr | Yes | Liver lesions with small-vessel thrombotic vasculopathy d | LMWH | 3.0 | PEd | LMWH | No (family reported) |
19 | 15 | 1°, Thr | Yes | Lower extremity DVTc | LMWH transitioned to warfarin | 36.8 | Portal vein thrombosis d | Warfarin | No (physician reported) |
74.8 | CVAd | Warfarin | No (physician reported) | ||||||
20 | 17 | 1°, Thr | No | Lower extremity DVTc | LMWH | 2.0 | PEc | None (suspected medication interaction on LMWH) | - |
2.9 | PEc | Warfarin (subtherapeutic) transitioning to LMWH | Yes | ||||||
4.0 | PEd | LMWH | No (physician reported) | ||||||
11.6 | PE with secondary pulmonary infarctiond | Fondaparinux and LDA | Yes |
Pt Patient number, AC Anticoagulation, 1° Primary AOS, 2° Secondary APS, Obs Obstetric, Thr Thrombotic, LDA Low dose aspirin, TMA Thrombotic Microangiopathy, PE pulmonary embolism, DVT Deep Vein Thrombosis, HELLP Hemolysis, Elevated Liver enzymes, Low Platelet count syndrome, LMWH Low molecular weight heparin (enoxaparin), CVA cerebrovascular accident. a2000-2004, b2005-2009, c2010-2014, d2015-2020