title: Validity of the global anti-phospholipid syndrome score to predict thrombosis: a prospective multicentre cohort study.
abstract: OBJECTIVE
  To investigate the validity of the global APS score (GAPSS) to predict thrombosis in patients with autoimmune diseases.
  
  
  METHODS
  This prospective cohort study included consecutive patients with aPL or SLE. aPL, aPS-PT and GAPSS were determined. A Cox proportional hazards model assessed the validity of GAPSS and identified other potential independent predictors of thrombosis.
  
  
  RESULTS
  One hundred and thirty-seven patients [43.5 (s.d. 15.4) years old; 107 women] were followed up for a mean duration of 43.1 (s.d. 20.7) months. Mean GAPSS was significantly higher in patients who experienced a thrombotic event compared with those without [10.88 (s.d. 5.06) vs 8.15 (s.d. 5.31), respectively, P = 0.038]. In univariate analysis, age [hazard ratio (HR) = 1.04 (95% CI 1.01, 1.08)] and GAPSS above 16 [HR = 6.86 (95% CI 1.90, 24.77)] were each significantly associated with thrombosis during follow-up, while history of arterial thrombosis [HR = 2.61 (95% CI 0.87, 7.82)] failed to reach significance. Among aPL assays, IgG aPS/PT--a component of the GAPSS--was significantly associated with thrombosis [HR = 2.95 (95% CI 1.02, 8.51)]. In multivariate analysis, GAPSS above 16 remained the only significant predictor of thrombosis [HR = 6.17 (95% CI 1.70, 22.40)].
  
  
  CONCLUSIONS
  This first external validation study confirmed that GAPSS can predict thrombosis in patients with aPL and associated autoimmune diseases.
authors.affiliation: CHU de Nancy, Regional Competence Centre for Rare Vascular and Systemic Autoimmune Diseases, Vascular Medicine Division, Inserm, UMRS 1116, Nancy School of Medicine, Université de Lorraine, Nancy, France, s.zuily@chu-nancy.fr.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Zuily
authors.affiliation: Biochemistry, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, Clinical Chemistry and Haematology, University Medical Centre Utrecht, Synapse BV, Maastricht, Department of Plasma Proteins/Blood coagulation, Sanquin Research, Amsterdam, The Netherlands.
authors.forename: Bas
authors.initials: B
authors.lastname: de Laat
authors.affiliation: Nancy School of Medicine, Université de Lorraine, Nancy, France, CHU de Nancy, Orphan Disease Unit, Nancy, France.
authors.forename: Shirine
authors.initials: S
authors.lastname: Mohamed
authors.affiliation: Biochemistry, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht.
authors.forename: Hilde
authors.initials: H
authors.lastname: Kelchtermans
authors.affiliation: Research and Development, Inova Diagnostics, San Diego, CA, USA.
authors.forename: Zakera
authors.initials: Z
authors.lastname: Shums
authors.affiliation: Research and Development, Inova Diagnostics, San Diego, CA, USA.
authors.forename: Roger
authors.initials: R
authors.lastname: Albesa
authors.affiliation: Research and Development, Inova Diagnostics, San Diego, CA, USA.
authors.forename: Gary L
authors.initials: GL
authors.lastname: Norman
authors.affiliation: CHU de Nancy, Regional Competence Centre for Rare Vascular and Systemic Autoimmune Diseases, Vascular Medicine Division.
authors.forename: Claire
authors.initials: C
authors.lastname: Lamboux-Matthieu
authors.affiliation: Université de Lorraine, Paris Descartes University, APEMAC, EA 4360, Inserm, CIC-EC 1433, CHU de Nancy, Clinical Epidemiology and Evaluation Department, CHU de Nancy, Rheumatology Department, Nancy.
authors.forename: Anne-Christine
authors.initials: AC
authors.lastname: Rat
authors.affiliation: CHU de Lyon, Department of Internal Medicine, Lyon.
authors.forename: Jacques
authors.initials: J
authors.lastname: Ninet
authors.affiliation: CHRU de Besançon, Internal Medicine Department, Besançon.
authors.forename: Nadine
authors.initials: N
authors.lastname: Magy-Bertrand
authors.affiliation: CHU de Strasbourg, Internal Medicine and Clinical Immunology Department, Strasbourg, F-67000.
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Pasquali
authors.affiliation: CHRU de Lille, Department of Internal Medicine, Lille.
authors.forename: Marc
authors.initials: M
authors.lastname: Lambert
authors.affiliation: CHU de Dijon, Internal Medicine and Clinical Immunology Department, Dijon and.
authors.forename: Bernard
authors.initials: B
authors.lastname: Lorcerie
authors.affiliation: Nancy School of Medicine, Université de Lorraine, Nancy, France, CHU de Nancy, Orphan Disease Unit, Nancy, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Kaminsky
authors.affiliation: Université de Lorraine, Paris Descartes University, APEMAC, EA 4360, Inserm, CIC-EC 1433, CHU de Nancy, Clinical Epidemiology and Evaluation Department.
authors.forename: Francis
authors.initials: F
authors.lastname: Guillemin
authors.affiliation: Inserm, UMRS 1116, CHU de Nancy, Contrat d'interface, Nancy, France.
authors.forename: Véronique
authors.initials: V
authors.lastname: Regnault
authors.affiliation: CHU de Nancy, Regional Competence Centre for Rare Vascular and Systemic Autoimmune Diseases, Vascular Medicine Division, Inserm, UMRS 1116, Nancy School of Medicine, Université de Lorraine, Nancy, France.
authors.forename: Denis
authors.initials: D
authors.lastname: Wahl
mesh_terms: D000328:Adult; D016736:Antiphospholipid Syndrome / Q000150:complications* / Q000175:diagnosis*; D001327:Autoimmune Diseases / Q000150:complications / Q000175:diagnosis; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013927:Thrombosis / Q000453:epidemiology*
keywords: anti-phosphatidylserine/prothrombin antibodies; antiphospholipid syndrome; global APS score; systemic lupus erythematosus; thrombosis