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- Title
Factors associated with first thrombosis in patients presenting with obstetric antiphospholipid syndrome (APS) in the APS Alliance for Clinical Trials and International Networking Clinical Database and Repository: a retrospective study.
- Authors
Jesús, GR; Sciascia, S; Andrade, D; Barbhaiya, M; Tektonidou, M; Banzato, A; Pengo, V; Ji, L; Meroni, PL; Ugarte, A; Cohen, H; Branch, DW; Andreoli, L; Belmont, HM; Fortin, PR; Petri, M; Rodriguez, E; Cervera, R; Knight, JS; Atsumi, T
- Abstract
<bold>Objective: </bold>To evaluate the subsequent rate of thrombosis among women with obstetric antiphospholipid syndrome (Ob-APS) in a multicentre database of antiphospholipid antibody (aPL)-positive patients, and the clinical utility of the adjusted Global Antiphospholipid Syndrome Score (aGAPSS), a validated tool to assess the likelihood of developing new thrombosis, in this group of patients.<bold>Design: </bold>Retrospective study.<bold>Setting: </bold>The Antiphospholipid Syndrome Alliance for Clinical Trials and International Networking Clinical Database and Repository.<bold>Population: </bold>Women with Ob-APS.<bold>Methods: </bold>Comparison of clinical and laboratory characteristics and measurement of aGAPSS in women with Ob-APS, with or without thrombosis, after initial pregnancy morbidity (PM).<bold>Main Outcome Measures: </bold>Risk factors for thrombosis and aGAPSS.<bold>Results: </bold>Of 550 patients, 126 had Ob-APS; 74/126 (59%) presented with thrombosis, and 47 (63%) of these women developed thrombosis after initial PM, in a mean time of 7.6 ± 8.2 years (4.9/100 patient years). Younger age at diagnosis of Ob-APS, additional cardiovascular risk factors, superficial vein thrombosis, heart valve disease, and multiple aPL positivity increased the risk of first thrombosis after PM. Women with thrombosis after PM had a higher aGAPSS compared with women with Ob-APS alone [median 11.5 (4-16) versus 9 (4-13); P = 0.0089].<bold>Conclusion: </bold>Based on a retrospective analysis of our multicentre aPL database, 63% of women with Ob-APS developed thrombosis after initial obstetric morbidity; additional thrombosis risk factors, selected clinical manifestations, and high-risk aPL profile increased the risk. Women with subsequent thrombosis after Ob-APS had a higher aGAPSS at entry to the registry. We believe that aGAPSS is a valid tool to improve risk stratification in aPL-positive women.<bold>Tweetable Abstract: </bold>More than 60% of women with obstetric antiphospholipid syndrome had thrombosis after initial pregnancy morbidity.
- Subjects
ANTIPHOSPHOLIPID syndrome; THROMBOSIS; HEART valve diseases; CLINICAL trials; PHOSPHOLIPID antibodies; RETROSPECTIVE studies; AUTOANTIBODIES; CARDIOVASCULAR diseases in pregnancy; COMPARATIVE studies; DATABASES; RESEARCH methodology; MEDICAL cooperation; RESEARCH; RESEARCH funding; EVALUATION research; ACQUISITION of data; DISEASE complications
- Publication
BJOG: An International Journal of Obstetrics & Gynaecology, 2019, Vol 126, Issue 5, p656
- ISSN
1470-0328
- Publication type
journal article
- DOI
10.1111/1471-0528.15469