RESEARCH - Risk factors for thrombosis and primary thrombosis prevention in patients with SLE with or without aPL

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Arthritis Rheum. 2008 Dec 30;61(1):29-36.

Risk factors for thrombosis and primary thrombosis prevention in

patients with systemic lupus erythematosus with or without

antiphospholipid antibodies.

Tektonidou MG, Laskari K, Panagiotakos DB, Moutsopoulos HM.

National University of Athens, Athens, Greece.

OBJECTIVE: Antiphospholipid antibodies (aPL), namely anticardiolipin

antibodies (aCL) and lupus anticoagulant (LAC), have been associated

with an increased risk of thrombosis in systemic lupus erythematosus

(SLE). We examined additional thrombosis risk factors (aPL profile,

SLE-related, and traditional risk factors) and the primary thrombosis

prevention in SLE patients with and without aPL.

METHODS: All SLE patients with positive aPL but without previous

thrombotic manifestations who were regularly followed up at our

department (n = 144) and 144 age- and sex-matched SLE patients with

negative aPL were included in this study. The median followup times

were 104 and 112 months, respectively. The demographic, clinical,

laboratory, and treatment characteristics and the traditional

thrombosis risk factors were recorded.

RESULTS: The thrombosis rate was 29 per 144 aPL-positive patients

(20.1%) and 11 per 144 aPL-negative patients (7.6%; P = 0.003). In

multiadjusted analysis, significant predictors of thrombosis were male

sex (hazard ratio

---

6.25, P < 0.01), LAC (HR 3.48, P = 0.04), and

constantly positive aCL (HR 5.87, P = 0.01) for aPL-positive patients,

while male sex (HR 7.14, P = 0.03) and hypertension were predictors

for aPL-negative patients (HR 6.49, P = 0.03). Additionally, the

duration of low-dose aspirin treatment played a protective role

against thrombosis in aPL-positive patients (HR per month 0.98, P =

0.05), as did the duration of hydroxychloroquine in both aPL-positive

(HR per month 0.99, P = 0.05) and aPL-negative patients (HR per month

0.98, P = 0.04).

CONCLUSION: Independent predictors of thrombosis for aPL-positive

patients were male sex, LAC, and constantly positive aCL, and for

aPL-negative patients were male sex and hypertension. The duration of

low-dose aspirin use played a protective role against thrombosis in

aPL-positive patients as did the duration of hydroxychloroquine in

both groups.

PMID: 19116963

http://www.ncbi.nlm.nih.gov/pubmed/19116963

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