Información del artículo
Resumen
La enfermedad tromboembólica venosa (ETV) es una enfermedad altamente prevalente, que requiere de seguimiento y tratamiento extendidos. Este seguimiento implica diversos aspectos clave: 1) completar el estudio etiológico y determinar el riesgo de recurrencia de futuros eventos tromboembólicos; 2) establecer la duración óptima del tratamiento anticoagulante, así como el tipo de terapia y su dosis; 3) estimar el riesgo de hemorragia, y 4) identificar la posible aparición de complicaciones crónicas. El presente documento, elaborado por el Grupo de Enfermedad Tromboembólica de la Sociedad Española de Medicina Interna, pretende actualizar y establecer recomendaciones sobre estos aspectos. El documento se centra en 4 aspectos del manejo: el primero incluye los factores de riesgo de recurrencia en la ETV no provocada y las escalas predictivas de recurrencia; el segundo se centra en los factores predictores de hemorragia; el tercero ofrece recomendaciones sobre el seguimiento a largo plazo en la ETV y aborda consideraciones específicas para el despistaje de la hipertensión pulmonar tromboembólica crónica y del síndrome postrombótico; y el cuarto brinda orientación sobre la duración óptima del tratamiento anticoagulante extendido, así como el tipo de terapia y su dosis. Para cada área se realizó una exhaustiva revisión bibliográfica analizando diferentes guías clínicas de la ETV y estudios recientes que han valorado los aspectos tratados en el artículo. El objetivo del documento es que sirva de ayuda en el manejo de la ETV a largo plazo basado en el conocimiento más actual.
Palabras clave:
Anticoagulación
Embolia de pulmón
Enfermedad tromboembólica venosa
Escalas de riesgo hemorrágico
Recurrencia
Síndrome postembolia de pulmón
Trombosis venosa profunda
Abstract
Venous thromboembolim (VTE) is a highly prevalent condition that requires long-term monitoring and treatment. This monitoring includes: 1) completing the etiological study and determining the risk of VTE recurrence; 2) establishing the optimal duration of anticoagulant treatment, as well as the type of therapy and its dosage; 3) estimating the risk of bleeding, and 4) identifying the occurrence of chronic complications. This consensus document, prepared by the VTE Group of the Spanish Society of Internal Medicine (SEMI), aims to update and establish consensus recommendations on these aspects. The document focuses on four aspects of management: the first includes risk factors for VTE recurrence after an unprovoked VTE episode and describes the predictive scores of VTE recurrence; the second focuses on risk factors for bleeding; the third provides recommendations for long-term follow-up in VTE, addressing specific considerations for screening chronic thromboembolic pulmonary hypertension and post-thrombotic syndrome of the lower limbs; and the fourth provides guidance on the optimal duration of extended anticoagulant treatment, as well as the type of therapy and its dosage;. For each area, an exhaustive literature review was conducted, analyzing the updated VTE clinical guidelines and recent studies. This document is intended to be a guide in the long-term management of VTE based on the most current knowledge.
Keywords:
Anticoagulation
Deep vein thrombosis
Hemorrhagic risk scores
Post-pulmonary embolism syndrome
Pulmonary embolism
Recurrence
Venous thromboembolism
Artículo
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