Prognostic factors and clustering of serious clinical outcomes in antiphospholipid syndrome

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dc.contributor.authorTektonidou, M. G.en
dc.contributor.authorIoannidis, J. P.en
dc.contributor.authorBoki, K. A.en
dc.contributor.authorVlachoyiannopoulos, P. G.en
dc.contributor.authorMoutsopoulos, H. M.en
dc.date.accessioned2015-11-24T18:56:22Z
dc.date.available2015-11-24T18:56:22Z
dc.identifier.issn1460-2725-
dc.identifier.urihttps://olympias.lib.uoi.gr/jspui/handle/123456789/19028
dc.rightsDefault Licence-
dc.subjectAdulten
dc.subjectAntibodies, Anticardiolipin/analysisen
dc.subjectAnticoagulants/adverse effects/therapeutic useen
dc.subjectAntiphospholipid Syndrome/*complications/drug therapy/immunologyen
dc.subjectAspirin/adverse effectsen
dc.subjectAutoantibodies/analysisen
dc.subjectCluster Analysisen
dc.subjectDisease Progressionen
dc.subjectEnzyme-Linked Immunosorbent Assayen
dc.subjectFemaleen
dc.subjectGlycoproteins/analysis/immunologyen
dc.subjectHumansen
dc.subjectImmunoglobulin G/immunologyen
dc.subjectImmunoglobulin M/immunologyen
dc.subjectMaleen
dc.subjectPrognosisen
dc.subjectProportional Hazards Modelsen
dc.subjectProspective Studiesen
dc.subjectRetrospective Studiesen
dc.subjectSeverity of Illness Indexen
dc.subjectTime Factorsen
dc.subjectWarfarin/adverse effectsen
dc.titlePrognostic factors and clustering of serious clinical outcomes in antiphospholipid syndromeen
heal.abstractWe 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.en
heal.accesscampus-
heal.fullTextAvailabilityTRUE-
heal.identifier.secondaryhttp://www.ncbi.nlm.nih.gov/pubmed/10924534-
heal.identifier.secondaryhttp://qjmed.oxfordjournals.org/content/93/8/523.full.pdf-
heal.journalNameQJMen
heal.journalTypepeer-reviewed-
heal.languageen-
heal.publicationDate2000-
heal.recordProviderΠανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικήςel
heal.typejournalArticle-
heal.type.elΆρθρο Περιοδικούel
heal.type.enJournal articleen

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