Background Antiphospholipid syndrome (APS) is an autoimmune disease defined by the presence of antiphospholipid antibodies (aPL) and thrombosis and/or pregnancy morbidity. Although thrombotic and obstetric APS are considered the same disorder, there are pathogenetic and clinical differences between them.
Objectives To describe the epidemiological, clinical and immunological characteristics of a cohort of APS patients from a defined population and to study the differences between thrombotic, obstetric and mixed APS.
Methods Retrospective study including patients attending the rheumatology and the obstetric clinics of a tertiary facility in Northern Spain. All patients met APS classification criteria.
Results We included 84 patients with thrombotic APS, 76 with obstetric APS and 10 with mixed APS. Main demographical characteristics are showed in table. There were differences in the age of discovery a positive serology (46±15 yr in thrombotic APS, 36±8 yr in obstetric, and 36±14 in mixed APS). Moreover, the prevalence of systemic lupus erythematosus (SLE) was higher in patients with thrombotic and mixed APS (26% and 30% vs 5% in obstetric APS, p=0.001). Anticardiolipin antibodies were, overall, the most frequently positive. Lupus anticoagulant was significantly more common in patients with thrombotic and mixed APS (70% and 71% vs 30% in obstetric APS, p=0.002). We found no differences in the load of antibodies between the three groups. Regarding traditional cardiovascular risk factors (CVRF), tobacco use was the most common, followed by hypertension and dyslipidemia. The last two factors were more frequent in patients with thrombotic and mixed APS than in those with obstetric APS (p<0.001). As expected, treatment with heparin was more frequent in obstetric and mixed APS, while oral anticoagulants were more frequently used in thrombotic APS. Antimalarial drugs were less frequently used in obstetric APS (17% vs 37% and 30%, p=0.020), probably due to a lower prevalence of lupus in this group.
Conclusions In our cohort, patients with thrombotic or mixed APS have a higher frequency of SLE than patients with obstetric APS. Positivity for lupus anticoagulant is more common in patients with thrombotic or mixed APS. Regarding traditional CVRF, hypertension and dislypidemia are more common in patients with thrombotic or mixed APS.
Disclosure of Interest None declared