Background Rheumatoid arthritis (RA), Systemic Lupus Erythematosus (SLE), Antiphospholipid syndrome (APS) are associated with increased mortality and co-morbidity compared with the general population. These patients (pts) may have an increased risk of developing venous thrombotic events (VTEs), based on the high prevalence of many known VTE risk factors (RF). Prevention of thrombosis should be taken commensurated with the risk of VTEs based on the composite risk profile (disease-related and concomitant RF).
Objectives To analyze thrombosis RF (concomitant and disease-related RF) in pts suffered from rheumatic diseases with thrombosis in past history.
Methods There were 45 pts (F:36 M:9), 44,8±13,4 years old: 5/45 (11%) pts with SLE, 12/45 (27%) with APS, 14/45 (31%) with SLE+APS and 15/45 (33%) with RA. All the pts had venous thrombosis in past history. We analyzed thrombosis RF (concomitant and disease-related risk factors) among the pts. High levels of antibodies to cardiolipin (aCL), beta 2-glycoprotein-1 (aB2GP1) were related to APS-related RF. Disease-related RF for RA and SLE were the disease activity, hypodynamia due to disease, glucocorticoid (GC) therapy, fractures due to GC and replacement arthroplasty as a main surgical operation. In 29/45 (64%) pts investigation of 4 markers of thrombophilia was performed as additional RF.
Results All the pts had different RF. 7/45 (16%) pts had surgical treatment before thrombosis. 11/34 (24%) pts with SLE and RA had the flare of disease (5/15 RA pts and 6/19 SLE pts). 10/45 (16%) pts had hypodynamia before thrombosis (in 2/10 cases because of nonspecific surgical treatment, 1/10 - replacement arthroplasty due to RA, 6/10 - the flare of disease). From 26 pts with APS 21 (81%) had high levels of aCl and 18 (69%) - high levels of aB2GP1. 8/45 (18%) pts had such RF as smoking, 10/45 (22%) – obesity (body mass index >30), 4/45 (9%) - long-lasting flights, 4/56 (9%) - traumas and 1/45 (2%) had fracture and further immobilization before thrombosis (fracture was not related to the therapy of rheumatic diseases). 22/45 (49%) pts received GC therapy (4 SLE, 8 SLE+APS and 10 RA). 7/36 (16%) women developed acute thrombosis during pregnancy and labor, 3/36 (8%) women received oral contraceptives. 25/29 (86%) pts had inherited thrombophilia. Frequency of RF did not differ between pts.
Conclusions Patients with RD have a higher risk of thromboembolic events. The most frequent RFs of thrombosis were GC therapy, surgical treatment, hypodynamia, antiphospholipid antibodies and inherited thrombophilia.
Disclosure of Interest None declared