Impact of hypertension and hyperhomocysteinemia on arterial thrombosis in primary antiphospholipid syndrome

Souza, Alexandre Wagner Silva de; Silva, N.P.; Carvalho, Jozélio Freire de; D’Almeida, Vânia; Noguti, Maria Aparecida Eiko; Sato, Élcio Hideo

doi:10.1177/0961203307081847

Cited by 39 publications

(31 citation statements)

References 31 publications

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“…On the other hand, this is a modifiable condition, and treatment of hypertension may be the most important intervention to reduce arterial thrombosis in these patients (45).…”

Section: Discussionmentioning

confidence: 99%

Association of arterial events with the coexistence of metabolic syndrome and primary antiphospholipid syndrome

Rodrigues

Bonfá

Caleiro

et al. 2012

Arthritis Care & Research

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Objective. Metabolic syndrome (MetS) is highly prevalent in rheumatic diseases and is recognized as a new independent cardiovascular risk factor. This study was undertaken to determine the clinical significance of MetS in patients with primary antiphospholipid syndrome (APS). Methods. Seventy-one primary APS patients and 73 age-and sex-matched healthy controls were included. Serum samples were tested for lipid profile, Lp(a), glucose, insulin, thyroid-stimulating hormone, free T4, erythrocyte sedimentation rate, C-reactive protein level, and uric acid. MetS was defined by the International Diabetes Federation criteria, and insulin resistance was established using the homeostasis model assessment index. Results. The prevalence of MetS was 33.8%, and further comparison between primary APS patients with and withoutMetS revealed that the former had a higher frequency of arterial events (79.2% versus 42.6%; P ‫؍‬ 0.003), angina (29.2% versus 2.1%; P ‫؍‬ 0.002), and positive lupus anticoagulant antibody (95.8% versus 76.6%; P ‫؍‬ 0.049). In addition, primary APS patients with MetS, as expected, had a higher prevalence of cardiovascular risk factors. On multivariate analysis, only MetS was independently associated with arterial events in primary APS. Conclusion. Coexistence of primary APS and MetS seems to identify a subgroup of patients with higher risk of arterial events, suggesting that MetS may aggravate existing endothelial abnormalities of primary APS.

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“…On the other hand, this is a modifiable condition, and treatment of hypertension may be the most important intervention to reduce arterial thrombosis in these patients (45).…”

Section: Discussionmentioning

confidence: 99%

Association of arterial events with the coexistence of metabolic syndrome and primary antiphospholipid syndrome

Rodrigues

Bonfá

Caleiro

et al. 2012

Arthritis Care & Research

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“…Significantly higher mean triglyceride levels and significantly lower mean HDL levels were previously reported among PAPS patients in comparison with controls [30][31][32][33]. Some specific autoantibodies could influence lipoprotein levels and effects in these patients.…”

Section: Metabolic Syndrome In Primary Antiphospholipid Syndrome Patimentioning

confidence: 61%

“…Different authors have observed similar prevalences of hypertension among PAPS patients (22.4 and 26.3%) [3,31], not differing significantly from that in controls (20%). Nevertheless, among PAPS patients, hypertension was significantly more frequent in those with arterial thrombosis, with which it was independently associated [31].…”

Section: Metabolic Syndrome In Primary Antiphospholipid Syndrome Patimentioning

confidence: 64%

“…These antibodies may interfere with paraoxonase (PON) activity of HDL and, indirectly, beta-2-glycoprotein I (beta-2-GPI) [32,33], thus promoting LDL oxidation. Relationships between lipid profile, certain anti-lipoprotein antibodies, inflammatory markers and clinical manifestations of PAPS were meticulously investigated [31][32][33], but on relatively small number of patients and with inconsistent results. Delgado Aves et al have not demonstrated any correlation between the observed decrease in PON activity and either aPL nor antibodies against HDL (anti-HDL) in PAPS patients [33].…”

Section: Metabolic Syndrome In Primary Antiphospholipid Syndrome Patimentioning

confidence: 99%

“…It has been also hypothesized that hypertriglyceridemia could be the result of decreased degradation as a consequence of an inhibition of lipoprotein lipase (LPL) by aPL [3]. Currently, there are only scarce data on prevalence of antibodies against LPL (anti-LPL) in PAPS patients, speaking against their existence and influence [31].…”

Section: Metabolic Syndrome In Primary Antiphospholipid Syndrome Patimentioning

confidence: 99%

See 2 more Smart Citations

Pathogenic and Therapeutic Role of Vitamin D in Antiphospholipid Syndrome Patients

Jelic¹,

Nikolic²,

Marisavljević³

et al. 2017

A Critical Evaluation of Vitamin D - Clinical Overview

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In this chapter, the novel findings on interrelationship between vitamin D status and two well-known prothrombotic states, antiphospholipid syndrome, particularly its thrombotic phenotype, and metabolic syndrome will be reviewed. We shall present the results obtained from patients included in Serbian National Antiphospholipid Syndrome Registry, 68 patients with primary antiphospholipid syndrome (PAPS) and 69 patients with antiphospholipid syndrome associated with certain autoimmune rheumatic disease (sAPS), as well as 50 patients with pure metabolic syndrome (MetS). These results will be analysed and compared with the novel literature data. Prevalence of MetS in APS is high, with the atherogenic dyslipidaemia as its most prevalent characteristic. Prevalence of thrombotic events was significantly higher in APS patients with coexisting MetS, compared with those without MetS. Among APS patients, prevalence of VitD deficiency was significantly higher than in patients with pure MetS.VitD level was also significantly lower in APS patients with coexisting MetS or previous thrombotic events than in those without them. Elucidating interrelationships between VitD deficiency, MetS and thrombotic events in APS patients open up the possibility of distinguishing those subjects with the particularly high cardiovascular risk and ensuing need for the strict control of modifiable risk factors and VitD supplementation.

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Lamivudine prophylaxis reduces the incidence and severity of hepatitis in hepatitis B virus carriers who receive chemotherapy for lymphoma

Jiang

et al. 2006

Cancer

102

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Objective Metabolic syndrome (MetS) is highly prevalent in rheumatic diseases and is recognized as a new independent cardiovascular risk factor. This study was undertaken to determine the clinical significance of MetS in patients with primary antiphospholipid syndrome (APS). Methods Seventy‐one primary APS patients and 73 age‐ and sex‐matched healthy controls were included. Serum samples were tested for lipid profile, Lp(a), glucose, insulin, thyroid‐stimulating hormone, free T4, erythrocyte sedimentation rate, C‐reactive protein level, and uric acid. MetS was defined by the International Diabetes Federation criteria, and insulin resistance was established using the homeostasis model assessment index. Results The prevalence of MetS was 33.8%, and further comparison between primary APS patients with and without MetS revealed that the former had a higher frequency of arterial events (79.2% versus 42.6%; P = 0.003), angina (29.2% versus 2.1%; P = 0.002), and positive lupus anticoagulant antibody (95.8% versus 76.6%; P = 0.049). In addition, primary APS patients with MetS, as expected, had a higher prevalence of cardiovascular risk factors. On multivariate analysis, only MetS was independently associated with arterial events in primary APS. Conclusion Coexistence of primary APS and MetS seems to identify a subgroup of patients with higher risk of arterial events, suggesting that MetS may aggravate existing endothelial abnormalities of primary APS.

show abstract

Impact of hypertension and hyperhomocysteinemia on arterial thrombosis in primary antiphospholipid syndrome

Cited by 39 publications

References 31 publications

Association of arterial events with the coexistence of metabolic syndrome and primary antiphospholipid syndrome

Association of arterial events with the coexistence of metabolic syndrome and primary antiphospholipid syndrome

Pathogenic and Therapeutic Role of Vitamin D in Antiphospholipid Syndrome Patients

Lamivudine prophylaxis reduces the incidence and severity of hepatitis in hepatitis B virus carriers who receive chemotherapy for lymphoma

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