Thrombotic risk factors in primary antiphospholipid syndrome: A 5-Year prospective study

Maurizio Turiel, Piercarlo Sarzi-Puttini, Rossana Peretti, Edoardo Rossi, Fabiola Atzeni, Wendy Parsons, Andrea Doria

Research output: Contribution to journalArticle

59 Citations (Scopus)

Abstract

Background and Purpose - Because thromboembolic events are frequently observed in primary antiphospholipid syndrome (PAPS), we assessed the risk factors for new thrombotic episodes. Methods - Fifty-six PAPS patients (mean age, 37±10 years) were prospectively studied for 5 years. The preliminary Sapporo classification criteria for antiphospholipid syndrome (APS; a medium-high anticardiolipin antibody [aCL] titer and/or a positive lupus anticoagulant [LA] test in the presence of vascular thrombosis and/or pregnancy morbidity) were used to confirm the diagnosis. Thrombotic episodes or pregnancy losses before a diagnosis of PAPS were considered events, and any new disease manifestation other than thrombocytopenia was considered a recurrent event. Only patients with objectively verified thrombotic events were included in the study. Results - Twenty-one new thrombotic events were observed in 15 subjects (26.8%), including 3 (5.4%) who died during the follow-up. The patients with IgG aCL levels of >40 IgG phospholipid unit (GPL-U) showed a higher incidence of new thrombotic events (43.3%) than those with levels of ≤40 GPL-U (7.7%). Univariate analysis identified a history of recurrent clinical events (P=0.004), a highly positive aCL titer (P=0.007), and the presence of cardiac abnormalities (P=0.036) as significant risk factors for new thrombotic events. A multivariate regression model confirmed that an IgG aCL titer of >40 GPL-U was an independent risk factor for thrombosis (odds ratio, 9.17; 95% confidence interval, 1.83 to 46.05). Conclusions - A high IgG aCL titer is the strongest predictor of new thrombotic events in PAPS patients.

Original languageEnglish
Pages (from-to)1490-1494
Number of pages5
JournalStroke
Volume36
Issue number7
DOIs
Publication statusPublished - Jul 2005

Fingerprint

Anticardiolipin Antibodies
Antiphospholipid Syndrome
Prospective Studies
Immunoglobulin G
Thrombosis
Lupus Coagulation Inhibitor
Pregnancy
Thrombocytopenia
Blood Vessels
Phospholipids
Odds Ratio
Confidence Intervals
Morbidity
Incidence

Keywords

  • Antiphospholipid syndrome
  • Echocardiography
  • Thrombosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Neuroscience(all)

Cite this

Turiel, M., Sarzi-Puttini, P., Peretti, R., Rossi, E., Atzeni, F., Parsons, W., & Doria, A. (2005). Thrombotic risk factors in primary antiphospholipid syndrome: A 5-Year prospective study. Stroke, 36(7), 1490-1494. https://doi.org/10.1161/01.STR.0000170645.40562.09

Thrombotic risk factors in primary antiphospholipid syndrome : A 5-Year prospective study. / Turiel, Maurizio; Sarzi-Puttini, Piercarlo; Peretti, Rossana; Rossi, Edoardo; Atzeni, Fabiola; Parsons, Wendy; Doria, Andrea.

In: Stroke, Vol. 36, No. 7, 07.2005, p. 1490-1494.

Research output: Contribution to journalArticle

Turiel, M, Sarzi-Puttini, P, Peretti, R, Rossi, E, Atzeni, F, Parsons, W & Doria, A 2005, 'Thrombotic risk factors in primary antiphospholipid syndrome: A 5-Year prospective study', Stroke, vol. 36, no. 7, pp. 1490-1494. https://doi.org/10.1161/01.STR.0000170645.40562.09
Turiel, Maurizio ; Sarzi-Puttini, Piercarlo ; Peretti, Rossana ; Rossi, Edoardo ; Atzeni, Fabiola ; Parsons, Wendy ; Doria, Andrea. / Thrombotic risk factors in primary antiphospholipid syndrome : A 5-Year prospective study. In: Stroke. 2005 ; Vol. 36, No. 7. pp. 1490-1494.
@article{f898d12f059a4acabd244062e74a2285,
title = "Thrombotic risk factors in primary antiphospholipid syndrome: A 5-Year prospective study",
abstract = "Background and Purpose - Because thromboembolic events are frequently observed in primary antiphospholipid syndrome (PAPS), we assessed the risk factors for new thrombotic episodes. Methods - Fifty-six PAPS patients (mean age, 37±10 years) were prospectively studied for 5 years. The preliminary Sapporo classification criteria for antiphospholipid syndrome (APS; a medium-high anticardiolipin antibody [aCL] titer and/or a positive lupus anticoagulant [LA] test in the presence of vascular thrombosis and/or pregnancy morbidity) were used to confirm the diagnosis. Thrombotic episodes or pregnancy losses before a diagnosis of PAPS were considered events, and any new disease manifestation other than thrombocytopenia was considered a recurrent event. Only patients with objectively verified thrombotic events were included in the study. Results - Twenty-one new thrombotic events were observed in 15 subjects (26.8{\%}), including 3 (5.4{\%}) who died during the follow-up. The patients with IgG aCL levels of >40 IgG phospholipid unit (GPL-U) showed a higher incidence of new thrombotic events (43.3{\%}) than those with levels of ≤40 GPL-U (7.7{\%}). Univariate analysis identified a history of recurrent clinical events (P=0.004), a highly positive aCL titer (P=0.007), and the presence of cardiac abnormalities (P=0.036) as significant risk factors for new thrombotic events. A multivariate regression model confirmed that an IgG aCL titer of >40 GPL-U was an independent risk factor for thrombosis (odds ratio, 9.17; 95{\%} confidence interval, 1.83 to 46.05). Conclusions - A high IgG aCL titer is the strongest predictor of new thrombotic events in PAPS patients.",
keywords = "Antiphospholipid syndrome, Echocardiography, Thrombosis",
author = "Maurizio Turiel and Piercarlo Sarzi-Puttini and Rossana Peretti and Edoardo Rossi and Fabiola Atzeni and Wendy Parsons and Andrea Doria",
year = "2005",
month = "7",
doi = "10.1161/01.STR.0000170645.40562.09",
language = "English",
volume = "36",
pages = "1490--1494",
journal = "Stroke",
issn = "0039-2499",
publisher = "Lippincott Williams and Wilkins",
number = "7",

}

TY - JOUR

T1 - Thrombotic risk factors in primary antiphospholipid syndrome

T2 - A 5-Year prospective study

AU - Turiel, Maurizio

AU - Sarzi-Puttini, Piercarlo

AU - Peretti, Rossana

AU - Rossi, Edoardo

AU - Atzeni, Fabiola

AU - Parsons, Wendy

AU - Doria, Andrea

PY - 2005/7

Y1 - 2005/7

N2 - Background and Purpose - Because thromboembolic events are frequently observed in primary antiphospholipid syndrome (PAPS), we assessed the risk factors for new thrombotic episodes. Methods - Fifty-six PAPS patients (mean age, 37±10 years) were prospectively studied for 5 years. The preliminary Sapporo classification criteria for antiphospholipid syndrome (APS; a medium-high anticardiolipin antibody [aCL] titer and/or a positive lupus anticoagulant [LA] test in the presence of vascular thrombosis and/or pregnancy morbidity) were used to confirm the diagnosis. Thrombotic episodes or pregnancy losses before a diagnosis of PAPS were considered events, and any new disease manifestation other than thrombocytopenia was considered a recurrent event. Only patients with objectively verified thrombotic events were included in the study. Results - Twenty-one new thrombotic events were observed in 15 subjects (26.8%), including 3 (5.4%) who died during the follow-up. The patients with IgG aCL levels of >40 IgG phospholipid unit (GPL-U) showed a higher incidence of new thrombotic events (43.3%) than those with levels of ≤40 GPL-U (7.7%). Univariate analysis identified a history of recurrent clinical events (P=0.004), a highly positive aCL titer (P=0.007), and the presence of cardiac abnormalities (P=0.036) as significant risk factors for new thrombotic events. A multivariate regression model confirmed that an IgG aCL titer of >40 GPL-U was an independent risk factor for thrombosis (odds ratio, 9.17; 95% confidence interval, 1.83 to 46.05). Conclusions - A high IgG aCL titer is the strongest predictor of new thrombotic events in PAPS patients.

AB - Background and Purpose - Because thromboembolic events are frequently observed in primary antiphospholipid syndrome (PAPS), we assessed the risk factors for new thrombotic episodes. Methods - Fifty-six PAPS patients (mean age, 37±10 years) were prospectively studied for 5 years. The preliminary Sapporo classification criteria for antiphospholipid syndrome (APS; a medium-high anticardiolipin antibody [aCL] titer and/or a positive lupus anticoagulant [LA] test in the presence of vascular thrombosis and/or pregnancy morbidity) were used to confirm the diagnosis. Thrombotic episodes or pregnancy losses before a diagnosis of PAPS were considered events, and any new disease manifestation other than thrombocytopenia was considered a recurrent event. Only patients with objectively verified thrombotic events were included in the study. Results - Twenty-one new thrombotic events were observed in 15 subjects (26.8%), including 3 (5.4%) who died during the follow-up. The patients with IgG aCL levels of >40 IgG phospholipid unit (GPL-U) showed a higher incidence of new thrombotic events (43.3%) than those with levels of ≤40 GPL-U (7.7%). Univariate analysis identified a history of recurrent clinical events (P=0.004), a highly positive aCL titer (P=0.007), and the presence of cardiac abnormalities (P=0.036) as significant risk factors for new thrombotic events. A multivariate regression model confirmed that an IgG aCL titer of >40 GPL-U was an independent risk factor for thrombosis (odds ratio, 9.17; 95% confidence interval, 1.83 to 46.05). Conclusions - A high IgG aCL titer is the strongest predictor of new thrombotic events in PAPS patients.

KW - Antiphospholipid syndrome

KW - Echocardiography

KW - Thrombosis

UR - http://www.scopus.com/inward/record.url?scp=22044440959&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=22044440959&partnerID=8YFLogxK

U2 - 10.1161/01.STR.0000170645.40562.09

DO - 10.1161/01.STR.0000170645.40562.09

M3 - Article

C2 - 15947270

AN - SCOPUS:22044440959

VL - 36

SP - 1490

EP - 1494

JO - Stroke

JF - Stroke

SN - 0039-2499

IS - 7

ER -