title: Thrombotic risk assessment in systemic lupus erythematosus: validation of the global antiphospholipid syndrome score in a prospective cohort.
abstract: OBJECTIVE
  This study was performed to prospectively and independently validate the Global Antiphospholipid Syndrome Score (GAPSS), a system derived from the combination of independent risk factors for thrombosis, including antiphospholipid antibodies (aPL) and conventional cardiovascular risk factors.
  
  
  METHODS
  The GAPSS was applied to 51 consecutive systemic lupus erythematosus patients, all positive for aPL and prospectively followed up for mean ± SD 32.94 ± 12.06 months. Of them, 48 were women with a mean ± SD age of 37.35 ± 12.15 years at entry. The GAPSS was calculated yearly for each patient by adding together the points corresponding to the risk factors.
  
  
  RESULTS
  An increase in the GAPSS (entry versus last visit) was seen in patients who experienced vascular events (n = 4, mean ± SD 7.5 ± 4.36 versus 10.0 ± 5.4; P = 0.032). No changes were observed in those without thrombosis (n = 47, mean ± SD 8.28 ± 4.88 versus 7.13 ± 5.75; P = 0.24). An increase in the GAPSS during the followup was associated with a higher risk of vascular events (relative risk 12.30 [95% confidence interval (95% CI) 1.43-106.13], P = 0.004), and an increase of more than 3 points showed the best risk accuracy for vascular events (hazard ratio 48 [95% CI 6.90-333.85], P = 0.0001). The cumulative proportion of thrombosis-free individuals was lower in patients whose GAPSS was increased by 3 or more points (P = 0.0027).
  
  
  CONCLUSIONS
  We have prospectively demonstrated that GAPSS is a valid tool for accurate prediction of vascular events in SLE patients with aPL.
authors: King's College, London, UK; Università di Torino, Turin, Italy.
authors: Savino
authors: S
authors: Sciascia
authors: Maria Jose
authors: MJ
authors: Cuadrado
authors: Giovanni
authors: G
authors: Sanna
authors: Veronica
authors: V
authors: Murru
authors: Dario
authors: D
authors: Roccatello
authors: Munther A
authors: MA
authors: Khamashta
authors: Maria Laura
authors: ML
authors: Bertolaccini
mesh_terms: D000328:Adult; D017152:Antibodies, Antiphospholipid / Q000097:blood* / Q000276:immunology; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000097:blood / Q000150:complications* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018570:Risk Assessment; D013927:Thrombosis / Q000097:blood / Q000209:etiology* / Q000276:immunology
chemical_list: D017152:Antibodies, Antiphospholipid