Prevención secundaria de la trombosis en pacientes con síndrome antifosfolípido

Antiphospholipid syndrome is very heterogeneous and is therefore of interest to various medical specialties. The neurologist will see it in cases of ischemic cerebrovascular disease. Retrospective clinical series suggest that treatment with high levels of anticoagulants (INR of 3 to 4.5), rather tha...

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Autor principal: Tapia,Jorge
Lenguaje:Spanish / Castilian
Publicado: Sociedad de Neurología, Psiquiatría y Neurocirugía 2003
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Acceso en línea:http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0717-92272003000400007
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Sumario:Antiphospholipid syndrome is very heterogeneous and is therefore of interest to various medical specialties. The neurologist will see it in cases of ischemic cerebrovascular disease. Retrospective clinical series suggest that treatment with high levels of anticoagulants (INR of 3 to 4.5), rather than at the usual levels (INR 2 to 3), decreases its recurrence. Crowther et al. published in the New England Journal of Medicine (2003; 349: 1133-8), the first prospective, randomized study evaluating the effectiveness and safety of oral anticoagulation at the two levels mentioned to prevent the recurrence of cerebral thrombosis. The authors conclude that a high-level use of anticoagulants does not give better results than a moderate-level use (INR 2 to 3). These results are crucial for neurologists, since the most serious complication arising from the use of anticoagulants is intracranial hemorrhage, whose primary risk factors are the level of anticoagulation and previous infarction. This study allows us to manage ischemic events in antiphospholipid antibody syndrome, with usual levels of anticoagulation