Thrombotic risk assessment in antiphospholipid syndrome: do noncriteria antibodies contribute?


Journal

Turkish journal of medical sciences
ISSN: 1303-6165
Titre abrégé: Turk J Med Sci
Pays: Turkey
ID NLM: 9441758

Informations de publication

Date de publication:
2023
Historique:
received: 28 05 2023
revised: 26 10 2023
accepted: 13 09 2023
medline: 30 5 2024
pubmed: 30 5 2024
entrez: 30 5 2024
Statut: epublish

Résumé

In this cross-sectional study, it was aimed to test the predictive value of noncriteria antiphospholipid antibodies (aPL) in addition to the global antiphospholipid syndrome score (GAPSS) in predicting vascular thrombosis (VT) in a cohort of patients with APS and aPL (+) systemic lupus erythematosus (SLE). This study included 50 patients with primary APS, 68 with SLE/APS, and 52 with aPL (+) SLE who were classified according to VT as VT ± pregnancy morbidity (PM), PM only or aPL (+) SLE. Antiphospholipid serology consisting of lupus anticoagulant (LA), anticardiolipin (aCL) immunoglobulin G (IgG)/IgM/IgA, antibeta2 glycoprotein I (aβ2GPI) IgG/IgM/IgA, antiphosphatidylserine/prothrombin (aPS/PT) IgG/IgM and antidomain-I (aDI) IgG was determined for each patient. The GAPSS and adjusted GAPSS (aGAPSS) were calculated for each patient, as previously defined. Logistic regression analysis was carried out with thrombosis as the dependent variable and high GAPSS, aCL IgA, aβ2GPI IgA, and aDI IgG as independent variables. The mean GAPSS and aGAPSS of the study population were 11.6 ± 4.4 and 9.6 ± 3.8. Both the VT ± PM APS (n = 105) and PM only APS (n = 13) groups had significantly higher GAPSS and aGAPSS values compared to the aPL (+) SLE (n = 52) group. The patients with recurrent thrombosis had higher aGAPSS but not GAPSS than those with a single thrombotic event. The computed area under the receiver operating characteristic curve demonstrated that a GAPSS ≥13 and aGAPSS ≥10 had the best predictive values for thrombosis. Logistic regression analysis including a GAPSS ≥13, aCL IgA, aβ2GPI IgA, and aDI IgG showed that none of the factors other than a GAPSS ≥13 could predict thrombosis. Both the GAPSS and aGAPSS successfully predict the thrombotic risk in aPL (+) patients and aCL IgA, aβ2GPI IgA, and aDI IgG do not contribute to high a GAPSS or aGAPSS.

Sections du résumé

Background/aim UNASSIGNED
In this cross-sectional study, it was aimed to test the predictive value of noncriteria antiphospholipid antibodies (aPL) in addition to the global antiphospholipid syndrome score (GAPSS) in predicting vascular thrombosis (VT) in a cohort of patients with APS and aPL (+) systemic lupus erythematosus (SLE).
Material and methods UNASSIGNED
This study included 50 patients with primary APS, 68 with SLE/APS, and 52 with aPL (+) SLE who were classified according to VT as VT ± pregnancy morbidity (PM), PM only or aPL (+) SLE. Antiphospholipid serology consisting of lupus anticoagulant (LA), anticardiolipin (aCL) immunoglobulin G (IgG)/IgM/IgA, antibeta2 glycoprotein I (aβ2GPI) IgG/IgM/IgA, antiphosphatidylserine/prothrombin (aPS/PT) IgG/IgM and antidomain-I (aDI) IgG was determined for each patient. The GAPSS and adjusted GAPSS (aGAPSS) were calculated for each patient, as previously defined. Logistic regression analysis was carried out with thrombosis as the dependent variable and high GAPSS, aCL IgA, aβ2GPI IgA, and aDI IgG as independent variables.
Results UNASSIGNED
The mean GAPSS and aGAPSS of the study population were 11.6 ± 4.4 and 9.6 ± 3.8. Both the VT ± PM APS (n = 105) and PM only APS (n = 13) groups had significantly higher GAPSS and aGAPSS values compared to the aPL (+) SLE (n = 52) group. The patients with recurrent thrombosis had higher aGAPSS but not GAPSS than those with a single thrombotic event. The computed area under the receiver operating characteristic curve demonstrated that a GAPSS ≥13 and aGAPSS ≥10 had the best predictive values for thrombosis. Logistic regression analysis including a GAPSS ≥13, aCL IgA, aβ2GPI IgA, and aDI IgG showed that none of the factors other than a GAPSS ≥13 could predict thrombosis.
Conclusion UNASSIGNED
Both the GAPSS and aGAPSS successfully predict the thrombotic risk in aPL (+) patients and aCL IgA, aβ2GPI IgA, and aDI IgG do not contribute to high a GAPSS or aGAPSS.

Identifiants

pubmed: 38813003
doi: 10.55730/1300-0144.5671
pii: turkjmedsci-53-5-1067
pmc: PMC10763812
doi:

Substances chimiques

Antibodies, Antiphospholipid 0
Antibodies, Anticardiolipin 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1067-1074

Informations de copyright

© TÜBİTAK.

Déclaration de conflit d'intérêts

Conflict of interest: The authors do not have any conflicts of interest.

Auteurs

Ömer Uludağ (Ö)

Division of Rheumatology, Department of Internal Medicine, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkiye.

Suzan Çinar (S)

Department of Immunology, Aziz Sancar Institute of Experimental Medicine, İstanbul University, İstanbul, Turkiye.

Thomas McDonnell (T)

Centre for Rheumatology Research, Division of Medicine, University College London, London, United Kingdom.

Erhan Çene (E)

Department of Statistics, Faculty of Arts and Science, Yıldız Technical University, İstanbul, Turkiye.

Yasemin Yalçinkaya (Y)

Division of Rheumatology, Department of Internal Medicine, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkiye.

Ahmet Gül (A)

Division of Rheumatology, Department of Internal Medicine, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkiye.

Murat Inanç (M)

Division of Rheumatology, Department of Internal Medicine, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkiye.

Bahar Artim Esen (B)

Division of Rheumatology, Department of Internal Medicine, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkiye.

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Classifications MeSH