• Joseph Emmerich, Stéphane Zuily, Isabelle Gouin-Thibault, Pierre-Emmanuel Morange, Francis Couturaud, and Menno Huisman.
• Department of Vascular Medicine, Paris Saint-Joseph Hospital Group, University of Paris, 75014 Paris, France; INSERM CRESS UMR 1153, F-75005 Paris, France; FCRIN INNOVTE network, Saint-Etienne, France. Electronic address: jemmerich@ghpsj.fr.
• Presse Med. 2024 Sep 6; 53 (4): 104247104247.

AbstractHypercoagulable states, also called thrombophilia, can either be congenital or acquired. Congenital thrombophilia, associated mainly with venous thrombosis, is either secondary to coagulation-inhibitor deficiencies, i.e., antithrombin, protein C and Protein S, or gain of function mutations, i.e., factor V Leiden and prothrombin G20210A mutations. Despite the relative frequency of these two mutations, they have not been associated with venous thrombosis recurrence. Most prevalent thrombophilia have a limited impact and usually does not change indications for duration of antithrombotic treatment or prophylaxis compared to decisions based on clinical factors. However, rare inherited thrombophilia such as antithrombin deficiency could justify a long-term anticoagulation. The main acquired thrombophilia, the Antiphospholipid syndrome (APS), is associated with both arterial and venous thrombosis. Its impact on patient management is significant: choice of the anticoagulant (DOAC vs. warfarin), duration of anticoagulation, screening of any organ involvement and systemic autoimmune disease, introduction of immunosuppressive therapy.Copyright © 2024. Published by Elsevier Masson SAS.

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