Prognostic factors and clustering of serious clinical outcomes in antiphospholipid syndrome

Tektonidou, MG; Ioannidis, JPA; Boki, KA; Vlachoyiannopoulos, PG; Moutsopoulos, HM

dc.contributor.author	Tektonidou, MG	en
dc.contributor.author	Ioannidis, JPA	en
dc.contributor.author	Boki, KA	en
dc.contributor.author	Vlachoyiannopoulos, PG	en
dc.contributor.author	Moutsopoulos, HM	en
dc.date.accessioned	2014-03-01T01:50:08Z
dc.date.available	2014-03-01T01:50:08Z
dc.date.issued	2000	en
dc.identifier.issn	1460-2725	en
dc.identifier.uri	https://dspace.lib.ntua.gr/xmlui/handle/123456789/26002
dc.subject.classification	Medicine, General & Internal	en
dc.subject.other	SYSTEMIC LUPUS-ERYTHEMATOSUS	en
dc.subject.other	PRELIMINARY CLASSIFICATION CRITERIA	en
dc.subject.other	ANTICARDIOLIPIN ANTIBODIES	en
dc.subject.other	RECOGNIZE BETA(2)-GLYCOPROTEIN-I	en
dc.subject.other	REVISED CRITERIA	en
dc.subject.other	FOLLOW-UP	en
dc.subject.other	THROMBOSIS	en
dc.subject.other	BETA-2-GLYCOPROTEIN-I	en
dc.subject.other	ASSOCIATION	en
dc.subject.other	BINDING	en
dc.title	Prognostic factors and clustering of serious clinical outcomes in antiphospholipid syndrome	en
heal.type	journalArticle	en
heal.language	English	en
heal.publicationDate	2000	en
heal.abstract	We assessed whether initial clinical presentations suggestive of antiphospholipid syndrome (APS) predicted the subsequent rate and type of serious clinical outcomes. Eighty-two consecutive patients with anticardiolipin antibodies or lupus anticoagulant were followed for 814 person-years after a first event suggestive of APS (livedo reticularis, thrombocytopenia, autoimmune haemolysis, thrombosis, central nervous system manifestations, recurrent abortions). The hazard of developing a second event was largest in patients with antibodies recognizing beta 2 glycoprotein I who had autoimmune haemolysis as the first event (hazard ratio HR 2.70, p = 0.018) and smallest in patients without such antibodies who had recurrent abortions as their first event (HR 0.37, p = 0.028). Subsequent serious events in patients with venous and arterial thromboses, recurrent abortions, central nervous system manifestations and autoimmune haemolytic anaemia were likely to be of the same type as the presenting event (odds ratio (OR) 3.76, 5.90, 77.7, 6.92, and 7.13, respectively). Adjusting for therapy, the rate of subsequent serious events was 6.86-fold higher (p = 0.0001) in patients presenting with two events, 1.56-fold higher (p = 0.038) in autoimmune haemolysis presentations, 1.69-fold higher (p = 0.004) in patients with anti-beta 2-glycoprotein-I antibodies, and 46% (p = 0.063) lower in thrombocytopenia presentations. Initial clinical features determine the long-term evolution of APS, and specific types of clinical manifestations cluster during the course of the disease.	en
heal.publisher	OXFORD UNIV PRESS	en
heal.journalName	QJM-MONTHLY JOURNAL OF THE ASSOCIATION OF PHYSICIANS	en
dc.identifier.isi	ISI:000088755900005	en
dc.identifier.volume	93	en
dc.identifier.issue	8	en
dc.identifier.spage	523	en
dc.identifier.epage	530	en