Analysis of causes for initial antithrombotic therapy failure and the establishment of an antithrombotic pathway in arterial and venous thrombosis complicated with antiphospholipid syndrome
- VernacularTitle:动静脉血栓伴抗磷脂综合征初始抗栓治疗失败原因分析与抗栓路径建立
- Author:
Yu GUAN
1
;
Zhu SHEN
1
;
Zhu ZHU
1
Author Information
1. Dept. of Pharmacy，the Second Affiliated Hospital of Soochow University，Jiangsu Suzhou 215004，China
- Publication Type:Journal Article
- Keywords:
arterial and venous thrombosis;
antiphospholipid syndrome;
antithrombosis;
initial treatment failure;
pathway
- From:
China Pharmacy
2025;36(20):2582-2587
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To investigate the potential causes of initial antithrombotic therapy failure and establish an antithrombotic pathway in arterial and venous thrombosis complicated with antiphospholipid syndrome （APS）， aiming to optimize clinical treatment. METHODS A retrospective analysis was conducted on three patients with arterial and venous thrombosis accompanied by APS； by integrating clinical data， laboratory tests， imaging findings， and treatment processes， key factors contributing to initial antithrombotic therapy failures were summarized. The antithrombotic pathway in arterial and venous thrombosis complicated with APS was established through a review of relevant literature. RESULTS & CONCLUSIONS The causes of initial antithrombotic treatment failure in 3 patients included selecting direct oral anticoagulants as the first choice for antithrombotic therapy， using antiplatelet drugs such as aspirin alone， and applying standard antithrombotic regimens to patients with refractory APS complicated by immune diseases like systemic lupus erythematosus. The coping strategies in the established antithrombotic pathway are as follows： for venous thromboembolic events， secondary prevention of thrombosis is the core and warfarin is the first choice； for arterial thromboembolic events， single use of antiplatelet drugs has limited efficacy and vitamin K antagonists should be used in combination for anticoagulation； for patients with combined vascular risk factors but without high bleeding risk， warfarin combined with antiplatelet drugs is preferred； for refractory APS， a stepped treatment regimen should be adopted， which involves first optimizing warfarin， then switching to therapeutic-dose low-molecular-weight heparin， and switching to fondaparinux if the treatment is ineffective or the patient is complicated by heparin-induced thrombocytopenia.
