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Clinical course of high‐risk patients diagnosed with antiphospholipid syndrome

Journal of thrombosis and haemostasis, 2010-02, Vol.8 (2), p.237-242 [Peer Reviewed Journal]

2009 International Society on Thrombosis and Haemostasis ;ISSN: 1538-7933 ;ISSN: 1538-7836 ;EISSN: 1538-7836 ;DOI: 10.1111/j.1538-7836.2009.03674.x ;PMID: 19874470

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Title:
Clinical course of high‐risk patients diagnosed with antiphospholipid syndrome
Author: PENGO, V. ; RUFFATTI, A. ; LEGNANI, C. ; GRESELE, P. ; BARCELLONA, D. ; ERBA, N. ; TESTA, S. ; MARONGIU, F. ; BISON, E. ; DENAS, G. ; BANZATO, A. ; PADAYATTIL JOSE, S. ; ILICETO, S.
Subjects: Administration, Oral ; Adult ; Aged ; Antibodies, Anticardiolipin - blood ; Antibodies, Antiphospholipid - blood ; anticoagulants ; Anticoagulants - administration & dosage ; Anticoagulants - adverse effects ; Antiphospholipid Syndrome - complications ; Antiphospholipid Syndrome - diagnosis ; Antiphospholipid Syndrome - drug therapy ; Antiphospholipid Syndrome - immunology ; Antiphospholipid Syndrome - mortality ; beta 2-Glycoprotein I - immunology ; Biomarkers - blood ; Catastrophic Illness ; diagnosis ; Disease Progression ; Female ; Galli ; Hemorrhage - chemically induced ; Humans ; Incidence ; Italy ; Kaplan-Meier Estimate ; lupus anticoagulant ; Lupus Coagulation Inhibitor - blood ; Male ; Middle Aged ; phospholipids ; Predictive Value of Tests ; Pregnancy ; Pregnancy Complications, Cardiovascular - drug therapy ; Pregnancy Complications, Cardiovascular - etiology ; Pregnancy Complications, Cardiovascular - immunology ; Pregnancy Complications, Cardiovascular - mortality ; Proportional Hazards Models ; Recurrence ; Retrospective Studies ; Risk Assessment ; Risk Factors ; thrombosis ; Time Factors ; Treatment Outcome ; Venous Thromboembolism - drug therapy ; Venous Thromboembolism - etiology ; Venous Thromboembolism - immunology ; Venous Thromboembolism - mortality
Is Part Of: Journal of thrombosis and haemostasis, 2010-02, Vol.8 (2), p.237-242
Description: See also Galli M. The antiphospholipid triangle. This issue, pp 234–6. Summary. Background: The characteristics and the clinical course of antiphospholipid syndrome (APS) in high‐risk patients that are positive for all three recommended tests that detect the presence of antiphospholipid (aPL) antibodies have not been described. Methods: This retrospective analysis of prospectively collected data examined patients referred to Italian Thrombosis Centers that were diagnosed with definite APS and tested positive for aPL [lupus anticoagulant (LA), anti‐cardiolipin (aCL), and anti‐β2‐glycoprotein I (β2GPI) antibodies]. Laboratory data were confirmed in a central reference laboratory. Results: One hundred and sixty patients were enrolled in this cohort study. The qualifying events at diagnosis were venous thromboembolism (76 cases; 47.5%), arterial thromboembolism (69 cases; 43.1%) and pregnancy morbidity (11 cases; 9.7%). The remaining four patients (2.5%) suffered from catastrophic APS. The cumulative incidence of thromboembolic events in the follow‐up period was 12.2% (95%CI, 9.6–14.8) after 1 year, 26.1% (95%CI, 22.3–29.9) after 5 years and 44.2% (95%CI, 38.6–49.8) after 10 years. This was significantly higher in those patients not taking oral anticoagulants as compared with those on treatment (HR=2.4 95%CI 1.3–4.1; P < 0.003). Major bleeding associated with oral anticoagulant therapy was low (0.8% patient/years). Ten patients died (seven were cardiovascular deaths). Conclusions: Patients with APS and triple positivity for aPL are at high risk of developing future thromboembolic events. Recurrence remains frequent despite the use of oral anticoagulants, which significantly reduces the risk of thromboembolism.
Publisher: Oxford, UK: Blackwell Publishing Ltd
Language: English
Identifier: ISSN: 1538-7933
ISSN: 1538-7836
EISSN: 1538-7836
DOI: 10.1111/j.1538-7836.2009.03674.x
PMID: 19874470
Source: MEDLINE
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Clinical course of high‐risk patients diagnosed with antiphospholipid syndrome

2009 International Society on Thrombosis and Haemostasis ;ISSN: 1538-7933 ;ISSN: 1538-7836 ;EISSN: 1538-7836 ;DOI: 10.1111/j.1538-7836.2009.03674.x ;PMID: 19874470

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