Influence of the antiphospholipid syndrome in the survival of patients with systemic lupus erythematosus.
OBJECTIVE
To determine prognostic factors for mortality in a cohort of 667 patients with systemic lupus erythematosus (SLE) including those variables associated with the presence of antiphospholipid antibodies (aPL) as well as antiphospholipid syndrome (APS) itself.


METHODS
Analysis of the cohort under a nested case control design by means of Cox proportional hazards regression with and without stepwise method.


RESULTS
During the 2039 person-years of followup, there were 49 deaths (cases). Thrombocytopenia, arterial occlusions, and hemolytic anemia were the aPL related manifestations that were associated with decreased survival in univariate analyses. The first 2 were also selected among risk factors for mortality in stepwise Cox multivariate analysis. The syndrome itself was also associated with increased mortality rates, independently of other variables.


CONCLUSIONS
APS is among the variables that confer decreased survival on patients with SLE. This decreased survival is due to some (e.g., thrombocytopenia or arterial occlusions), but not all, of the manifestations of APS.
Drenkard
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C
Department of Immunology and Rheumatology, Instituto Nacional de la Nutrición Salvador Zubirán, Mexico City, Mexico.
Villa
A R
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Alarcón-Segovia
D
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Pérez-Vázquez
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ME
D000743:Anemia, Hemolytic / Q000150:complications; D016736:Antiphospholipid Syndrome / Q000150:complications*; D001157:Arterial Occlusive Diseases / Q000150:complications; D015331:Cohort Studies; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000401:mortality; D015999:Multivariate Analysis; D011379:Prognosis; D016016:Proportional Hazards Models; D012307:Risk Factors; D016019:Survival Analysis; D013921:Thrombocytopenia / Q000150:complications