Cardiology Letters 2026, 35(2):90-98

What a cardiologist should know about the need for thrombophilia screening - the latest recommendations

Juraj Sokol¹, František Nehaj^2,3, Peter Hlivák^2,3, Lenka Lisá¹, Ľudmila Lineková¹, Richard Jusko¹, Ivana Plameňová¹, Pavol Hollý¹, Ján Staško¹

¹ Klinika hematológie a transfuziológie, Jesseniova lekárska fakulta v Martine, Univerzita Komenského v Bratislave

² Klinika arytmológie, Lekárska fakulta v Bratislave, Univerzita Komenského v Bratislave

³ Oddelenie arytmológie a kardiostimulácie, Národný ústav srdcových a cievnych chorôb, a. s., Bratislava, Slovenská republika

Thrombophilia represents a congenital or acquired predisposition to thrombosis; however, its assessment is clinically meaningful only in situations where it can influence therapeutic or preventive management. The overuse of thrombophilia screening in cardiology practice remains a frequent problem despite its limited benefit in many clinical settings. Current evidence and the latest 2025 recommendations of the Slovak Society of Hemostasis and Thrombosis emphasize the need for a selective and rational approach. Screening is mainly indicated in young patients with unprovoked or recurrent venous thromboembolism, thrombosis at atypical sites, or specific pregnancy-related complications, when the result can affect the duration or type of anticoagulant therapy or guide genetic counseling. Conversely, testing is not recommended in patients with thrombosis clearly provoked by major surgery, trauma, or prolonged immobilization, nor in asymptomatic individuals without a strong family history. The choice and timing of tests must also take into account biological and pharmacological interferences, particularly during acute thrombosis or ongoing anticoagulation therapy. For cardiologists, it is crucial to understand that thrombophilia screening should be a targeted rather than a routine examination. Unjustified testing increases costs, the risk of misinterpretation, and may lead to unnecessary long-term anticoagulant therapy. A rational, evidence-based approach ensures that thrombophilia testing remains a tool for individualized patient care rather than an automatic part of diagnostics.

Keywords: indication; screening; thrombophilia

Published: February 1, 2026  Show citation