title: Risk factors for a first thrombotic event in antiphospholipid antibody carriers: a prospective multicentre follow-up study.
abstract: OBJECTIVE
  To assess risk factors for a first thrombotic event in confirmed antiphospholipid (aPL) antibody carriers and to evaluate the efficacy of prophylactic treatments.
  
  
  METHODS
  Inclusion criteria were age 18-65 years, no history of thrombosis and two consecutive positive aPL results. Demographic, laboratory and clinical parameters were collected at enrolment, once a year during the follow-up and at the time of the thrombotic event, whenever that occurred.
  
  
  RESULTS
  258 subjects were prospectively observed between October 2004 and October 2008. The mean ± SD follow-up was 35.0 ± 11.9 months (range 1-48). A first thrombotic event (9 venous, 4 arterial and 1 transient ischaemic attack) occurred in 14 subjects (5.4%, annual incidence rate 1.86%). Hypertension and lupus anticoagulant (LA) were significantly predictive of thrombosis (both at p<0.05) and thromboprophylaxis was significantly protective during high-risk periods (p<0.05) according to univariate analysis. Hypertension and LA were identified by multivariate logistic regression analysis as independent risk factors for thrombosis (HR 3.8, 95% CI 1.3 to 11.1, p<0.05, and HR 3.9, 95% CI 1.1 to 14, p<0.05, respectively).
  
  
  CONCLUSIONS
  Hypertension and LA are independent risk factors for thrombosis in aPL carriers. Thromboprophylaxis in these subjects should probably be limited to high-risk situations.
authors.affiliation: Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Padua, Padua, Italy. amelia.ruffatti@unipd.it
authors.forename: Amelia
authors.initials: A
authors.lastname: Ruffatti
authors.forename: Teresa
authors.initials: T
authors.lastname: Del Ross
authors.forename: Manuela
authors.initials: M
authors.lastname: Ciprian
authors.forename: Maria T
authors.initials: MT
authors.lastname: Bertero
authors.forename: Savino
authors.initials: S
authors.lastname: Sciascia
authors.forename: Sciascia
authors.initials: S
authors.lastname: Salvatore
authors.forename: Salvatore
authors.initials: S
authors.lastname: Scarpato
authors.forename: Carlomaurizio
authors.initials: C
authors.lastname: Montecucco
authors.forename: Silvia
authors.initials: S
authors.lastname: Rossi
authors.forename: Paola
authors.initials: P
authors.lastname: Caramaschi
authors.forename: Domenico
authors.initials: D
authors.lastname: Biasi
authors.forename: Andrea
authors.initials: A
authors.lastname: Doria
authors.forename: Mariaelisa
authors.initials: M
authors.lastname: Rampudda
authors.forename: Nuzzo
authors.initials: N
authors.lastname: Monica
authors.forename: Fabio
authors.initials: F
authors.lastname: Fischetti
authors.forename: Ugo
authors.initials: U
authors.lastname: Picillo
authors.forename: Antonio
authors.initials: A
authors.lastname: Brucato
authors.forename: Elisa
authors.initials: E
authors.lastname: Salvan
authors.forename: Pengo
authors.initials: P
authors.lastname: Vittorio
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Meroni
authors.forename: Angela
authors.initials: A
authors.lastname: Tincani
mesh_terms: D000328:Adult; D017152:Antibodies, Antiphospholipid / Q000097:blood; D016736:Antiphospholipid Syndrome / Q000150:complications* / Q000276:immunology; D001323:Autoantibodies / Q000097:blood; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications; D016682:Lupus Coagulation Inhibitor / Q000097:blood; D008297:Male; D008875:Middle Aged; D013927:Thrombosis / Q000209:etiology* / Q000276:immunology / Q000517:prevention & control; D055815:Young Adult
chemical_list: D017152:Antibodies, Antiphospholipid; D001323:Autoantibodies; D016682:Lupus Coagulation Inhibitor