Antiphospholipid antibodies and the risk of thromboembolic events in valvular heart disease.
OBJECTIVE
To investigate the role of antiphospholipid antibodies (aPLs) in subsequent thromboembolic events and mortality in a prospective follow-up of 89 patients with severe, nonspecific valvular heart disease.


METHODS
Between November 1, 1993, and March 31, 1994, 89 patients with valvular heart disease were assessed for the presence of anticardiolipin antibodies and lupus anticoagulant. The primary end point was thromboembolic events, and the secondary end points were cardiovascular mortality and overall mortality.


RESULTS
All patients were followed up for a mean of 59 months; 1 patient (without aPLs) was lost to follow-up. Nineteen patients had increased titers of aPLs. Thromboembolic events were significantly more frequent in the aPL-positive group than in the aPL-negative group (7/19 [37%] vs 8/70 [11%]; P=.01). Cardiovascular mortality tended to be higher in the aPL-positive group than in the aPL-negative group (3 [16%] vs 6 [9%]; P = .40). However, in multivariate Cox analysis, presence of aPLs was not an independent risk factor for thromboembolic events.


CONCLUSIONS
Our results suggest that patients with severe valvular heart disease and aPLs have an increased risk for developing thromboembolic events.
Bulckaen
Hélène G
HG
Service de Médecine Interne et Gériatrie, Hôpital Gériatrique les Bateliers, Centre Hospitalier Régional et Universitaire de Lille, 59037 Lille, France.
Puisieux
François L
FL
Bulckaen
Emmanuel D
ED
Di Pompeo
Christophe
C
Bouillanne
Olivier M
OM
Watel
Annie A
AA
Fauchais
Anne-Laure M
AL
De Groote
Pascal
P
Millaire
Alain
A
D017153:Antibodies, Anticardiolipin / Q000032:analysis; D017152:Antibodies, Antiphospholipid / Q000032:analysis; D016736:Antiphospholipid Syndrome / Q000150:complications*; D002318:Cardiovascular Diseases / Q000209:etiology / Q000401:mortality; D005260:Female; D006349:Heart Valve Diseases / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D016682:Lupus Coagulation Inhibitor / Q000032:analysis; D008180:Lupus Erythematosus, Systemic / Q000150:complications; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D013923:Thromboembolism / Q000209:etiology*
D017153:Antibodies, Anticardiolipin; D017152:Antibodies, Antiphospholipid; D016682:Lupus Coagulation Inhibitor