title: Analysis of risk factors for the development of thrombotic complications in antiphospholipid antibody positive lupus patients.
abstract: The objective of this study was to characterize risk factors for thrombotic events in lupus patients. A total of 272 lupus patients were followed up for five years during which the presence of aPL antibodies [anticardiolipin (aCL), anti-beta2-glycoprotein I (abeta2GPI) and lupus anticoagulant (LAC)] were determined, and all thrombotic incidents and antithrombotic therapy-related data were collected. At baseline, three groups were constituted, an aPL- group with 107 aPL negative patients, an aPL+ group with 81 aPL positive patients without clinical thrombosis and a secondary antiphospholipid syndrome (APS) group with 84 aPL+ patients who met the Sapporo criteria. LAC was more common in the APS than the aPL+ group (32.1% versus 9.9%, P < 0.001). The prevalence of clinical thrombotic events was significantly higher when all three types of aPL were present compared to only aCL positive cases. During follow up, aPL appeared in 7.5% of the aPL- group, and 2.8% of this group had thrombotic complications. In the aPL+ group, thrombotic events reoccurred in 1.9% of those receiving antithrombotic prophylaxis and 6.9% of those without primary prophylaxis. Despite anticoagulant therapy, thrombotic events reoccurred in 8.3% of the APS group. These findings indicate that LAC, constant and cumulative presence of aPL and previous thrombosis are positive predictors for the development of thrombotic complication in lupus patients.
authors.affiliation: Department of Clinical Immunology, Medical and Health Science Centre, University of Debrecen, Debrecen, Hungary.
authors.forename: T
authors.initials: T
authors.lastname: Tarr
authors.forename: G
authors.initials: G
authors.lastname: Lakos
authors.forename: H P
authors.initials: HP
authors.lastname: Bhattoa
authors.forename: Y
authors.initials: Y
authors.lastname: Shoenfeld
authors.forename: G
authors.initials: G
authors.lastname: Szegedi
authors.forename: E
authors.initials: E
authors.lastname: Kiss
mesh_terms: D000328:Adult; D017153:Antibodies, Anticardiolipin / Q000097:blood / Q000276:immunology; D017152:Antibodies, Antiphospholipid / Q000097:blood* / Q000276:immunology; D000918:Antibody Specificity; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use; D016736:Antiphospholipid Syndrome / Q000453:epidemiology / Q000209:etiology* / Q000276:immunology; D001324:Autoantigens / Q000276:immunology; D005260:Female; D005343:Fibrinolytic Agents / Q000009:adverse effects / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D016682:Lupus Coagulation Inhibitor / Q000097:blood; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D019851:Thrombophilia / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology* / Q000276:immunology; D013927:Thrombosis / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D053482:beta 2-Glycoprotein I / Q000276:immunology
chemical_list: D017153:Antibodies, Anticardiolipin; D017152:Antibodies, Antiphospholipid; D000925:Anticoagulants; D001324:Autoantigens; D005343:Fibrinolytic Agents; D016682:Lupus Coagulation Inhibitor; D010975:Platelet Aggregation Inhibitors; D053482:beta 2-Glycoprotein I