Polskie Archiwum Medycyny Wewnętrznej
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Pol. Arch. Med. Wewn. · Nov 2024
ReviewHow to treat patients with thrombotic antiphospholipid syndrome in 2024?
Antiphospholipid syndrome (APS) encompasses a range of clinical conditions, particularly thrombotic or obstetrical manifestations, associated with the presence of antiphospholipid antibodies. Managing thrombotic APS in daily clinical practice can be challenging and requires thorough risk stratification and tailored treatment strategies. Primary prophylaxis focuses on correcting the traditional thrombotic risk factors and, in certain situations, may include low‑dose aspirin and / or prophylactic anticoagulants (eg, low‑molecular‑weight heparin). ⋯ In some cases, a combination of VKAs and low‑dose aspirin, increased doses of VKAs with an international normalized ratio target greater than 3, or a switch to therapeutic doses of low‑molecular‑weight heparin might be employed. The use of hydroxychloroquine is essential in patients with secondary systemic lupus erythematosus and may be considered in individuals with recurrent thrombosis. In other selected situations, the use of immunomodulatory agents can be considered.
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Pol. Arch. Med. Wewn. · Nov 2024
Addition of Tilburg frailty indicator to the classic Global Registry of Acute Coronary Events risk score improves its prognostic value in elderly patients with acute coronary syndrome.
Since proper risk stratification in a growing population of patients with acute coronary syndrome (ACS) is challenging, a potential advantage of adding the elements of geriatric assessment to the commonly used Global Registry of Acute Coronary Events (GRACE) 2.0 scale in predicting the risk of 6‑month death requires investigation. ⋯ Adding the FS assessment to the traditional GRACE scale improves its prognostic value in elderly patients with ACS.