Risk factors for a first thrombotic event in antiphospholipid antibody carriers. A multicentre, retrospective follow-up study.
OBJECTIVE
To asses risk factors for a first thrombotic event in antiphospholipid antibody (aPL) positive carriers and evaluate the efficacy of prophylactic treatments.


METHODS
Recruitment criteria were age 18-65 years, no history of thrombosis, positivity for lupus anticoagulant and/or IgG/IgM anticardiolipin antibody (aCL) on > or =2 occasions at least 6 weeks apart. Demographic, laboratory and clinical parameters were collected at enrolment and at the time of the thrombotic event.


RESULTS
370 patients/subjects (mean (SD) age 34 (9.9) years) were analysed retrospectively for a mean (SD) follow-up of 59.3 (45.5) months. Thirty patients (8.1%) developed a first thrombotic event during follow-up. Hypertension and medium/high levels of IgG aCL were identified by multivariate logistic regression analysis as independent risk factors for thrombosis. Thromboprophylaxis during high-risk and long-term periods was significantly protective.


CONCLUSIONS
Hypertension or medium/high titres of IgG aCL are risk factors for a first thrombotic event in asymptomatic aPL carriers and primary prophylaxis is protective.
Ruffatti
A
A
Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Padua, Padua, Italy. amelia.ruffatti@unipd.it
Del Ross
T
T
Ciprian
M
M
Nuzzo
M
M
Rampudda
M
M
Bertero
M T
MT
Bergia
R
R
Caramaschi
P
P
Biasi
D
D
Capsoni
F
F
Montaguti
L
L
Ruffini
R
R
Brucato
A
A
Picillo
U
U
Fanelli
V
V
Riccieri
V
V
Piccoli
A
A
Valesini
G
G
Doria
A
A
Meroni
P L
PL
Tincani
A
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D017153:Antibodies, Anticardiolipin / Q000097:blood; D017152:Antibodies, Antiphospholipid / Q000097:blood*; D016736:Antiphospholipid Syndrome / Q000235:genetics / Q000276:immunology*; D004812:Epidemiologic Methods; D005260:Female; D006579:Heterozygote; D006801:Humans; D006973:Hypertension / Q000150:complications; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D008875:Middle Aged; D013927:Thrombosis / Q000209:etiology* / Q000276:immunology / Q000517:prevention & control; D055815:Young Adult
D017153:Antibodies, Anticardiolipin; D017152:Antibodies, Antiphospholipid; D007074:Immunoglobulin G