Risk factors for a first thrombotic event in antiphospholipid antibody carriers. A multicentre, retrospective follow-up study
- A Ruffatti1,
- T Del Ross1,
- M Ciprian1,
- M Nuzzo2,
- M Rampudda1,
- M T Bertero3,
- R Bergia3,
- P Caramaschi4,
- D Biasi4,
- F Capsoni5,
- L Montaguti6,
- R Ruffini6,
- A Brucato7,
- U Picillo8,
- V Fanelli9,
- V Riccieri10,
- A Piccoli11,
- G Valesini10,
- A Doria1,
- P L Meroni9,
- A Tincani2
- 1Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Padua, Padua, Italy
- 2Rheumatology and Clinical Immunology Units, University of Brescia, Brescia, Italy
- 3Clinical Immunology and Allergology Units, Mauriziano Hospital, Turin, Italy
- 4Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Verona, Verona, Italy
- 5Rheumatology Unit, IRCCS Galeazzi, University of Milan, Milan, Italy
- 6Rheumatology Unit, Bufalini Hospital, Cesena, Italy
- 7Department of Internal Medicine, Hospital of Bergamo, Bergamo, Italy
- 8Institute of Clinical Medicine, II University of Naples, Naples, Italy
- 9Department of Internal Medicine, Auxologico Institute, University of Milan, Milan, Italy
- 10Rheumatology Unit, Department of Clinical Medicine and Medical Therapy, University La Sapienza, Rome, Italy
- 11Nephrology Unit, Department of Medical and Surgical Sciences, University of Padua, Padua, Italy
- Professor A Ruffatti, Rheumatology Unit, Policlinico Universitario, Via Giustiniani, 2–35128 Padova, Italy;
- Accepted 6 September 2008
- Published Online First 23 September 2008
Objectives: To asses risk factors for a first thrombotic event in antiphospholipid antibody (aPL) positive carriers and evaluate the efficacy of prophylactic treatments.
Methods: Recruitment criteria were age 18–65 years, no history of thrombosis, positivity for lupus anticoagulant and/or IgG/IgM anticardiolipin antibody (aCL) on ⩾2 occasions at least 6 weeks apart. Demographic, laboratory and clinical parameters were collected at enrolment and at the time of the thrombotic event.
Results: 370 patients/subjects (mean (SD) age 34 (9.9) years) were analysed retrospectively for a mean (SD) follow-up of 59.3 (45.5) months. Thirty patients (8.1%) developed a first thrombotic event during follow-up. Hypertension and medium/high levels of IgG aCL were identified by multivariate logistic regression analysis as independent risk factors for thrombosis. Thromboprophylaxis during high-risk and long-term periods was significantly protective.
Conclusions: Hypertension or medium/high titres of IgG aCL are risk factors for a first thrombotic event in asymptomatic aPL carriers and primary prophylaxis is protective.
Competing interests: None.
The authors are members of the APS Study Group of the Italian Society of Rheumatology.
Ethics approval: Ethics committee approval obtained.