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Thromboembolism in peripartum cardiomyopathy: a systematic review

Archanna Radakrishnan1, Julia Dokko2, Paola Pastena3

  • 1Department of Medicine, Stony Brook University, Stony Brook, NY, USA.

Journal of Thoracic Disease
|February 27, 2024
PubMed

Insights

Women with peripartum cardiomyopathy face high risks of blood clots. This review details clot incidence, risk factors, diagnosis, and treatments, highlighting the need for more research.

Area of Science:

  • Cardiology
  • Obstetrics
  • Hematology

Background:

  • Peripartum cardiomyopathy (PPCM) significantly increases the risk of arterial and venous thromboembolic events in women.
  • Understanding these complications is crucial for maternal health management.

Purpose of the Study:

  • To review the current evidence on thromboembolic complications in women with PPCM.
  • To summarize incidence, diagnostic methods, outcomes, and therapeutic interventions.

Main Methods:

  • A systematic literature search was conducted using Web of Science and PubMed.
  • Articles were screened for data on epidemiology, risk factors, diagnosis, and therapy of thromboembolism in PPCM.
  • 30 relevant articles were included for data synthesis.

Main Results:

  • Thromboembolism incidence in PPCM varies, reaching up to 14% within 6 months.
  • Risk factors include elevated coagulation factors, decreased protein C/S activity, low LVEF, and cesarean delivery.
  • Diagnosis primarily uses ultrasonography and MRI; anticoagulation is common for reduced LVEF, with varied treatment protocols.

Conclusions:

  • Significant knowledge gaps exist regarding PPCM-related thromboembolism epidemiology and risk stratification.
  • Further large-scale prospective studies with detailed phenotyping are essential for optimizing secondary prevention.
Abstract

Keywords:
Peripartum cardiomyopathy (PPCM)anticoagulationembolismthromboembolismthrombosis

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