title: Clinical consequences of antiphospholipid antibodies: an historic cohort study.
abstract: OBJECTIVE
  To determine the risk of antiphospholipid antibody-related disorders in women with elevated levels of these antibodies.
  
  
  METHODS
  We used an historic cohort study design. Surveys of medical and obstetric histories for the interval from initial antibody testing to the time of patient interview were used to calculate age-adjusted rates for the development of medical disorders associated with antiphospholipid antibodies. The cohort included 130 women with lupus anticoagulant, medium to high levels of immunoglobulin G anticardiolipin antibodies, or both.
  
  
  RESULTS
  The median interval of study was 3.2 years (range 0.7-9.5, mean 3.7). Sixty-three subjects (48%) developed at least one new disorder during the study interval. The age-adjusted rates (per 1000 patient-years; +/- standard error) for the development of the disorders studied were as follows: thrombosis (156.8 +/- 30.0), cerebrovascular accident (93.8 +/- 25.1), amaurosis fugax (57.1 +/- 23.2), transient ischemic attack (170.4 +/- 27.6), systemic lupus erythematosus (9.8 +/- 3.8), and autoimmune thrombocytopenia (56.0 +/- 22.2). Of the 34 thrombotic events that occurred during the study interval, eight were associated with pregnancy and eight occurred while the patients were taking anticoagulant medications.
  
  
  CONCLUSIONS
  Our subjects developed complications associated with antiphospholipid antibodies at a substantial rate, and almost half suffered at least one new event during the study interval. The high rate of thrombosis in individuals with antiphospholipid antibodies, especially associated with pregnancy, underscores the need to evaluate long-term anticoagulation in these patients.
authors.affiliation: Department of Obstetrics and Gynecology, University of Utah School of Medicine, Salt Lake City.
authors.forename: R M
authors.initials: RM
authors.lastname: Silver
authors.forename: M L
authors.initials: ML
authors.lastname: Draper
authors.forename: J R
authors.initials: JR
authors.lastname: Scott
authors.forename: J L
authors.initials: JL
authors.lastname: Lyon
authors.forename: J
authors.initials: J
authors.lastname: Reading
authors.forename: D W
authors.initials: DW
authors.lastname: Branch
mesh_terms: D000328:Adult; D017152:Antibodies, Antiphospholipid / Q000097:blood*; D016736:Antiphospholipid Syndrome / Q000453:epidemiology*; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D016015:Logistic Models; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D012306:Risk; D012307:Risk Factors; D013927:Thrombosis / Q000453:epidemiology*
chemical_list: D017152:Antibodies, Antiphospholipid