Risk factors associated with thrombosis in patients with antiphospholipid antibodies.
OBJECTIVE
To define risk factors associated with thrombosis in patients with antiphospholipid antibodies (aPL).


METHODS
Ninety-nine patients with aPL, most of whom had prior thrombosis, were evaluated for the presence of acquired and inherited thrombophilic states. Genomic testing was performed for factor V(R506Q), 3' prothrombin (PTG) and methylene tetrahydrofolate reductase (MTHFR) polymorphisms. Clinical records were reviewed for the presence of acquired risk factors (RF) for thrombosis and events associated with aPL. Univariate statistical analysis was performed using Fisher's exact testing. A neural network statistical model was also used to identify which thrombophilic risk factors were most important in development of arterial and venous thrombosis.


RESULTS
For arterial thrombosis, hypertension, tobacco use, hyperlipidemia, and diabetes mellitus were the most important predictors of thrombosis. By contrast, tobacco use, the 3' PTG and factor V(R506Q) polymorphisms, and previous cardiac surgery were the most important predictors of venous thrombosis.


CONCLUSIONS
In this hypothesis-generating retrospective study, acquired risk factors were most important in arterial thrombosis, while the presence of factor V(R506Q) and 3' PTG polymorphisms were more important in the development of venous thrombosis. These findings are being validated in an ongoing, prospective study.
Hansen
K E
KE
Department of Medicine, Duke University Medical Center, Durham, NC 27710, USA.
Kong
D F
DF
Moore
K D
KD
Ortel
T L
TL
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000704:Analysis of Variance; D017152:Antibodies, Antiphospholipid / Q000032:analysis*; D001157:Arterial Occlusive Diseases / Q000453:epidemiology* / Q000276:immunology*; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011336:Probability; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012494:Sampling Studies; D017678:Sex Distribution; D020246:Venous Thrombosis / Q000453:epidemiology* / Q000276:immunology*
D017152:Antibodies, Antiphospholipid