Prognostic factors and clustering of serious clinical outcomes in antiphospholipid syndrome
Φόρτωση...
Ημερομηνία
Συγγραφείς
Tektonidou, M. G.
Ioannidis, J. P.
Boki, K. A.
Vlachoyiannopoulos, P. G.
Moutsopoulos, H. M.
Τίτλος Εφημερίδας
Περιοδικό ISSN
Τίτλος τόμου
Εκδότης
Περίληψη
Τύπος
Είδος δημοσίευσης σε συνέδριο
Είδος περιοδικού
peer-reviewed
Είδος εκπαιδευτικού υλικού
Όνομα συνεδρίου
Όνομα περιοδικού
QJM
Όνομα βιβλίου
Σειρά βιβλίου
Έκδοση βιβλίου
Συμπληρωματικός/δευτερεύων τίτλος
Περιγραφή
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 beta2 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-beta2-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.
Περιγραφή
Λέξεις-κλειδιά
Adult, Antibodies, Anticardiolipin/analysis, Anticoagulants/adverse effects/therapeutic use, Antiphospholipid Syndrome/*complications/drug therapy/immunology, Aspirin/adverse effects, Autoantibodies/analysis, Cluster Analysis, Disease Progression, Enzyme-Linked Immunosorbent Assay, Female, Glycoproteins/analysis/immunology, Humans, Immunoglobulin G/immunology, Immunoglobulin M/immunology, Male, Prognosis, Proportional Hazards Models, Prospective Studies, Retrospective Studies, Severity of Illness Index, Time Factors, Warfarin/adverse effects
Θεματική κατηγορία
Παραπομπή
Σύνδεσμος
http://www.ncbi.nlm.nih.gov/pubmed/10924534
http://qjmed.oxfordjournals.org/content/93/8/523.full.pdf
http://qjmed.oxfordjournals.org/content/93/8/523.full.pdf
Γλώσσα
en
Εκδίδον τμήμα/τομέας
Όνομα επιβλέποντος
Εξεταστική επιτροπή
Γενική Περιγραφή / Σχόλια
Ίδρυμα και Σχολή/Τμήμα του υποβάλλοντος
Πανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικής