Elevated partial antiphospholipid score is a strong risk factor for thrombosis in patients with systemic lupus erythematosus: a validation study

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• 作者：Jie Chen ; Shuhui Sun ; Qingran Yan ; Chunde Bao ; Qiong Fu
• 关键词：Antiphospholipid antibody ; Antiphospholipid syndrome ; Lupus ; Thrombosis
• 刊名：Clinical Rheumatology
• 出版年：2016
• 出版时间：February 2016
• 年：2016
• 卷：35
• 期：2
• 页码：333-340
• 全文大小：451 KB
• 参考文献：1.Bazzan M, Vaccarino A, Marletto F (2015) Systemic lupus erythematosus and thrombosis. Thromb J 13:16. doi:10.​1186/​s12959-015-0043-3 PubMedCentral CrossRef PubMed
  2.Mok CC, Tang SS, To CH, Petri M (2005) Incidence and risk factors of thromboembolism in systemic lupus erythematosus: a comparison of three ethnic groups. Arthritis Rheum 52(9):2774–2782CrossRef PubMed
  3.Tektonidou MG, Laskari K, Panagiotakos DB, Moutsopoulos HM (2009) Risk factors for thrombosis and primary thrombosis prevention in patients with systemic lupus erythematosus with or without antiphospholipid antibodies. Arthritis Rheum 61(1):29–36CrossRef PubMed
  4.Mustonen P, Lehtonen KV, Javela K, Puurunen M (2014) Persistent antiphospholipid antibody (aPL) in asymptomatic carriers as a risk factor for future thrombotic events: a nationwide prospective study. Lupus 23:1468–1476CrossRef PubMed
  5.Galli M (2012) Interpretation and recommended testing for antiphospholipid antibodies. Semin Thromb Hemost 38(4):348–352CrossRef PubMed
  6.Somers E, Magder LS, Petri M (2002) Antiphospholipid antibodies and incidence of venous thrombosis in a cohort of patients with systemic lupus erythematosus. J Rheumatol 29(12):2531–2536PubMed
  7.Galli M, Luciani D, Bertolini G, Barbui T (2003) Lupus anticoagulants are stronger risk factors for thrombosis than anticardiolipin antibodies in the antiphospholipid syndrome: a systematic review of the literature. Blood 101(5):1827–1832CrossRef PubMed
  8.Tarr T, Lakos G, Bhattoa HP, Shoenfeld Y, Szegedi G, Kiss E (2007) Analysis of risk factors for the development of thrombotic complications in antiphospholipid antibody positive lupus patients. Lupus 16(1):39–45CrossRef PubMed
  9.Martinez-Berriotxoa A, Ruiz-Irastorza G, Egurbide MV, Garmendia M, Gabriel Erdozain J, Villar I et al (2007) Transiently positive anticardiolipin antibodies and risk of thrombosis in patients with systemic lupus erythematosus. Lupus 16(10):810–816CrossRef PubMed
  10.Danowski A, Kickler TS, Petri M (2006) Anti-beta2-glycoprotein I: prevalence, clinical correlations, and importance of persistent positivity in patients with antiphospholipid syndrome and systemic lupus erythematosus. J Rheumatol 33(9):1775–1779PubMed
  11.Otomo K, Atsumi T, Amengual O, Fujieda Y, Kato M, Oku K et al (2012) Efficacy of the antiphospholipid score for the diagnosis of antiphospholipid syndrome and its predictive value for thrombotic events. Arthritis Rheum 64(2):504–512CrossRef PubMed
  12.Pengo V, Tripodi A, Reber G, Rand JH, Ortel TL, Galli M et al (2009) Update of the guidelines for lupus anticoagulant detection. Subcommittee on Lupus Anticoagulant/Antiphospholipid Antibody of the Scientific and Standardisation Committee of the International Society on Thrombosis and Haemostasis. J Thromb Haemost 7(10):1737–1740CrossRef PubMed
  13.Oku K, Amengual O, Atsumi T (2014) Antiphospholipid scoring: significance in diagnosis and prognosis. Lupus 23:1269–1272CrossRef PubMed
  14.Sciascia S, Bertolaccini ML, Roccatello D, Khamashta MA (2013) Independent validation of the antiphospholipid score for the diagnosis of antiphospholipid syndrome. Ann Rheum Dis 72(1):142–143CrossRef PubMed
  15.Jung H, Bobba R, Su J, Shariati-Sarabi Z, Gladman DD, Urowitz M et al (2010) The protective effect of antimalarial drugs on thrombovascular events in systemic lupus erythematosus. Arthritis Rheum 62(3):863–868CrossRef PubMed
  16.Ruffatti A, Del Ross T, Ciprian M, Bertero MT, Salvatore S, Scarpato S et al (2011) Risk factors for a first thrombotic event in antiphospholipid antibody carriers: a prospective multicentre follow-up study. Ann Rheum Dis 70(6):1083–1086CrossRef PubMed
  17.Sciascia S, Sanna G, Murru V, Roccatello D, Khamashta MA, Bertolaccini ML (2013) GAPSS: the Global Anti-Phospholipid Syndrome Score. Rheumatology (Oxford) 52(8):1397–1403CrossRef
  18.Sciascia S, Bertolaccini ML (2014) Thrombosis risk assessment in APS: the Global APS Score (GAPSS). Lupus 23:1287
  19.Sciascia S, Cuadrado MJ, Sanna G, Murru V, Roccatello D, Khamashta MA et al (2014) Thrombotic risk assessment in systemic lupus erythematosus: validation of the global antiphospholipid syndrome score (GAPSS) in a prospective cohort. Arthritis Care Res 66(12):1915–1920CrossRef
  20.Sciascia S, Sanna G, Murru V, Roccatello D, Khamashta MA, Bertolaccini ML (2015) The global anti-phospholipid syndrome score in primary APS. Rheumatology (Oxford) 54(1):134–138CrossRef
  21.Zuily S, de Laat B, Mohamed S, Kelchtermans H, Shums Z, Albesa R et al (2015) Validity of the global anti-phospholipid syndrome score to predict thrombosis: a prospective multicentre cohort study. Rheumatology (Oxford) 54(11):2071–2075CrossRef
  22.Sarabi ZS, Chang E, Bobba R, Ibanez D, Gladman D, Urowitz M et al (2005) Incidence rates of arterial and venous thrombosis after diagnosis of systemic lupus erythematosus. Arthritis Rheum 53(4):609–612CrossRef PubMed
  23.Romero-Diaz J, Garcia-Sosa I, Sanchez-Guerrero J (2009) Thrombosis in systemic lupus erythematosus and other autoimmune diseases of recent onset. J Rheumatol 36(1):68–75PubMed
  
• 作者单位：Jie Chen (1)
  Shuhui Sun (1)
  Qingran Yan (1)
  Chunde Bao (1)
  Qiong Fu (1)
  
  1. Department of Rheumatology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 145 Middle Shandong Road, Shanghai, 200021, China
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Rheumatology
  
• 出版者：Springer London
• ISSN：1434-9949

文摘

This study aims to identify risk factors for thrombosis in patients with systemic lupus erythematosus (SLE) and to validate the efficacy of the partial antiphospholipid (aPL) score for thrombosis prediction and diagnosis of antiphospholipid syndrome (APS). This study included 325 SLE patients, 188 of whom completed a follow-up of 31.01 months (range 23–48 months). Partial aPL score was calculated by adding up the individual scores for activated partial thromboplastin time (APTT), lupus anticoagulant, IgG/IgM anticardiolipin antibodies (aCL), and IgG/IgM anti-β2-glycoprotein I (anti-β2GPI). A simplified aPL score was developed using only APTT, IgG/IgM aCL, and IgG/IgM anti-β2GPI. Partial aPL scores were significantly higher in SLE patients with thrombosis (p < 0.0001). A history of thrombosis (p < 0.0001), a partial aPL score >10 (p < 0.0001), and immunosuppressant use (p = 0.012) were independent risk factors for thrombosis. For patients with a history of thrombosis, partial aPL score was the strongest risk factor for recurrent thrombosis (p < 0.0001, odds ratio = 30.34 (95 % CI 7.70–118.81)). For APS diagnosis, the area under the receiver-operating characteristic curve (AUC) was 0.809 (95 % CI 0.73–0.89) using the partial aPL score. Similarly, the simplified aPL score was significantly associated with thrombosis (p < 0.0001) and was acceptable for APS diagnosis (AUC 0.797, 95 % CI 0.72–0.88). An elevated partial aPL score is a strong risk factor for thrombosis in SLE patients and is a useful tool to predict recurrent thrombosis. Partial aPL score and simplified aPL score, although comprising fewer items than the original aPL score, also represent valuable quantitative indices for APS diagnosis. Keywords Antiphospholipid antibody Antiphospholipid syndrome Lupus Thrombosis