Recurrent thrombosis in patients with antiphospholipid antibodies and arterial thrombosis on antithrombotic therapy

Antiphospholipid Syndrome Alliance for Clinical Trials and International Networking, Pier Luigi Meroni

Research output: Contribution to journalArticle

Abstract

Management for patients with antiphospholipid syndrome (APS) and arterial thrombosis is controversial. There are no prospective data demonstrating the superiority of high- or moderate-intensity anticoagulation with vitamin K antagonists over antiplatelet agents. Using 2 antiphospholipid antibody databases (single center [New York Presbyterian Hospital] and multicenter [Antiphospholipid Syndrome Alliance for Clinical Trials and International Networking]), we retrospectively collected demographic and clinical data of patients with APS and arterial thrombosis. The primary outcome was recurrent thrombosis rate after initial arterial thrombosis in patients with APS treated with antiplatelet and/or anticoagulant therapy. We identified 139 patients with a median follow-up time of 4.24 years after initial thrombosis. Thirty-seven patients (27.3%) received anticoagulants, 43 (30.9%) antiplatelets, and 58 (41.7%) combined therapy. Sixteen patients (37.2%) in the antiplatelet group, 9 (23.7%) in the anticoagulant group, and 4 (6.9%) in the combined therapy group experienced recurrent thrombosis. We estimate that 20% of patients will experience a recurrence by 3.4, 7.3, and 16.3 years, respectively, depending on assignment to antiplatelet, anticoagulant, or combined therapy. These results suggest that combined therapy decreases the rate of and increases the time to thrombosis recurrence in patients with APS presenting with arterial thrombosis.

Original languageEnglish
Pages (from-to)2320-2324
Number of pages5
JournalBlood advances
Volume1
Issue number25
DOIs
Publication statusPublished - Nov 28 2017

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Antiphospholipid Antibodies
Anticoagulants
Thrombosis
Antiphospholipid Syndrome
Vitamin K
Platelet Aggregation Inhibitors
Therapeutics
Recurrence
Group Psychotherapy
Demography
Clinical Trials
Databases

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Recurrent thrombosis in patients with antiphospholipid antibodies and arterial thrombosis on antithrombotic therapy. / Antiphospholipid Syndrome Alliance for Clinical Trials and International Networking ; Meroni, Pier Luigi.

In: Blood advances, Vol. 1, No. 25, 28.11.2017, p. 2320-2324.

Research output: Contribution to journalArticle

Antiphospholipid Syndrome Alliance for Clinical Trials and International Networking & Meroni, PL 2017, 'Recurrent thrombosis in patients with antiphospholipid antibodies and arterial thrombosis on antithrombotic therapy', Blood advances, vol. 1, no. 25, pp. 2320-2324. https://doi.org/10.1182/bloodadvances.2017008185
Antiphospholipid Syndrome Alliance for Clinical Trials and International Networking ; Meroni, Pier Luigi. / Recurrent thrombosis in patients with antiphospholipid antibodies and arterial thrombosis on antithrombotic therapy. In: Blood advances. 2017 ; Vol. 1, No. 25. pp. 2320-2324.
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abstract = "Management for patients with antiphospholipid syndrome (APS) and arterial thrombosis is controversial. There are no prospective data demonstrating the superiority of high- or moderate-intensity anticoagulation with vitamin K antagonists over antiplatelet agents. Using 2 antiphospholipid antibody databases (single center [New York Presbyterian Hospital] and multicenter [Antiphospholipid Syndrome Alliance for Clinical Trials and International Networking]), we retrospectively collected demographic and clinical data of patients with APS and arterial thrombosis. The primary outcome was recurrent thrombosis rate after initial arterial thrombosis in patients with APS treated with antiplatelet and/or anticoagulant therapy. We identified 139 patients with a median follow-up time of 4.24 years after initial thrombosis. Thirty-seven patients (27.3{\%}) received anticoagulants, 43 (30.9{\%}) antiplatelets, and 58 (41.7{\%}) combined therapy. Sixteen patients (37.2{\%}) in the antiplatelet group, 9 (23.7{\%}) in the anticoagulant group, and 4 (6.9{\%}) in the combined therapy group experienced recurrent thrombosis. We estimate that 20{\%} of patients will experience a recurrence by 3.4, 7.3, and 16.3 years, respectively, depending on assignment to antiplatelet, anticoagulant, or combined therapy. These results suggest that combined therapy decreases the rate of and increases the time to thrombosis recurrence in patients with APS presenting with arterial thrombosis.",
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