Recognition and management of the hypercoagulable states: A decade of change

Hereditary and acquired thrombophilias are common causes of venous thromboembolism. Widely, available laboratory assays demonstrate that up to 25% of patients with a first deep venous thrombosis and as many as 60% of patients with recurrent venous thrombosis have one or more coagulation defects. Three important thrombotic disorders have been described in the last decade: hereditary resistance to activated protein C, homocyst(e)inemia, and antiphospholipid antibodies. Identification of patients with these abnormalities will help determine the duration and intensity of anticoagulant therapy, facilitate detection of affected family members, and allow effective antithrombotic prophylaxis during such high-risk situations as surgery, childbirth, or trauma. Finally, in some instances, specific treatment is available for managing these conditions.