title: Increased mortality in patients with the lupus anticoagulant: the Vienna Lupus Anticoagulant and Thrombosis Study (LATS).
abstract: Data on the clinical course of lupus anticoagulant (LA)-positive individuals with or without thrombotic manifestations or pregnancy complications are limited. To investigate mortality rates and factors that might influence mortality, we conducted a prospective observational study of LA-positive individuals. In total, 151 patients (82% female) were followed for a median of 8.2 years; 30 of the patients (20%) developed 32 thromboembolic events (15 arterial and 17 venous events) and 20 patients (13%) died. In univariable analysis, new onset of thrombosis (hazard ratio [HR] = 8.76; 95% confidence interval [CI], 3.46-22.16) was associated with adverse survival. Thrombosis remained a strong adverse prognostic factor after multivariable adjustment for age and hypertension (HR = 5.95; 95% CI, 2.43-14.95). Concomitant autoimmune diseases, anticoagulant treatment at baseline, or positivity for anticardiolipin- or anti-β2-glycoprotein I antibodies were not associated with mortality. In a relative survival analysis, our cohort of LA positives showed a persistently worse survival in comparison with an age-, sex-, and study-inclusion-year-matched Austrian reference population. The cumulative relative survival was 95.0% (95% CI, 88.5-98.8) after 5 years and 87.7% (95% CI, 76.3-95.6) after 10 years. We conclude that occurrence of a thrombotic event is associated with higher mortality in patients with LA. Consequently, the prevention of thromboembolic events in LA positives might improve survival.
authors: Department of Medicine I, Clinical Division of Hematology and Hemostaseology; and.
authors: Johanna
authors: J
authors: Gebhart
authors: Department of Medicine I, Clinical Division of Hematology and Hemostaseology; and.
authors: Florian
authors: F
authors: Posch
authors: Department of Medicine I, Clinical Division of Hematology and Hemostaseology; and.
authors: Silvia
authors: S
authors: Koder
authors: Department of Laboratory Medicine, Division of Medical and Chemical Laboratory Diagnostics, Medical University of Vienna, Vienna, Austria.
authors: Thomas
authors: T
authors: Perkmann
authors: Department of Laboratory Medicine, Division of Medical and Chemical Laboratory Diagnostics, Medical University of Vienna, Vienna, Austria.
authors: Peter
authors: P
authors: Quehenberger
authors: Department of Medicine I, Clinical Division of Hematology and Hemostaseology; and.
authors: Claudia
authors: C
authors: Zoghlami
authors: Department of Medicine I, Clinical Division of Hematology and Hemostaseology; and.
authors: Cihan
authors: C
authors: Ay
authors: Department of Medicine I, Clinical Division of Hematology and Hemostaseology; and.
authors: Ingrid
authors: I
authors: Pabinger
mesh_terms: D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use; D016736:Antiphospholipid Syndrome / Q000097:blood / Q000150:complications / Q000401:mortality*; D001317:Austria / Q000453:epidemiology; D016022:Case-Control Studies; D002423:Cause of Death; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016682:Lupus Coagulation Inhibitor / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology; D016019:Survival Analysis; D013927:Thrombosis / Q000097:blood / Q000150:complications / Q000401:mortality*
chemical_list: D000925:Anticoagulants; D016682:Lupus Coagulation Inhibitor