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Risk factors for a first thrombotic event in antiphospholipid antibody carriers. A multicenter retrospective follow-up study
  1. A Ruffatti (amelia.ruffatti{at}unipd.it)
  1. Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Padua, Italy
    1. T Del Ross
    1. Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Padua, Italy
      1. M Ciprian
      1. Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Padua, Italy
        1. M Nuzzo
        1. Rheumatology and Clinical Immunology Units, University of Brescia, Italy
          1. M Rampudda
          1. Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Padua, Italy
            1. M T Bertero
            1. Mauriziano Hospital, Turin, Italy
              1. R Bergia
              1. Mauriziano Hospital, Turin, Italy
                1. P Caramaschi
                1. Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Verona, Italy
                  1. D Biasi
                  1. Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Verona, Italy
                    1. F Capsoni
                    1. Rheumatology Unit, IRCCS Galeazzi, University of Milan, Italy
                      1. L Montaguti
                      1. Rheumatology Unit, Bufalini Hospital, Cesena, Italy
                        1. R Ruffini
                        1. Rheumatology Unit, Bufalini Hospital, Cesena, Italy
                          1. A Brucato
                          1. Department of Internal Medicine, Hospital of Bergamo, Italy
                            1. U Picillo
                            1. Insitute of Clinical Medicine, II University of Naples, Italy
                              1. V Fanelli
                              1. Department of Internal Medicine, Auxologico Institute, University of Milan, Italy
                                1. V Riccieri
                                1. Rheumatology Unit, Department of Clinical Medicine and Medical Therapy, University La Sapienza, Rome, Italy
                                  1. A Piccoli
                                  1. Nephrology Unit, Department of Medical and Surgical Sciences, University of Padua, Italy
                                    1. G Valesini
                                    1. Rheumatology Unit, Department of Clinical Medicine and Medical Therapy, University La Sapienza, Rome, Italy
                                      1. A Doria
                                      1. Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Padua, Italy
                                        1. PL Meroni
                                        1. Department of Internal Medicine, Auxologico Institute, University of Milan, Italy
                                          1. A Tincani
                                          1. Rheumatology and Clinical Immunology Units, University of Brescia, Italy

                                            Abstract

                                            Objectives: To asses risk factors for a first thrombotic event in antiphospholipid antibody (aPL) positive carriers and to 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 and/or IgM anticardiolipin antibody (aCL) on two or more occasions at least 6 weeks apart. Patients with antiphospholipid syndrome related pregnancy morbidity were included. Demographic, laboratory and clinical parameters were collected at enrollment and at the time of the thrombotic event.

                                            Results: We retrospectively analyzed 370 patients/subjects (344 women and 26 men; mean age: 34 years ± 9.9 SD, range 18-65) for a mean follow-up of 59.3 months ± 45.5 SD (range 5-239). Thirty patients (8.1%, annual incidence rate 1.64%) developed a first thrombotic event (60% arterial and 40% venous) during the 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: Our findings suggest that hypertension and/or medium/high titres of IgG aCL are risk factors for a first thrombotic event in asymptomatic aPL carriers and that primary prophylaxis is protective.

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