International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS)

Miyakis, Spiros; Lockshin, Michael D.; Atsumi, Tatsuya; Branch, D. Ware; Brey, Robin L.; Cervera, Ricard; Derksen, R. H. W. M.; Groot, Philip G. de; Koike, Takao; Meroni, Pier Luigi; Reber, Guido; Shoenfeld, Yehuda; Tincani, Anǵela; Vlachoyiannopoulos, Panayiotis G.; Krilis, Steven A.

doi:10.1111/j.1538-7836.2006.01753.x

Cited by 6,291 publications

(6,401 citation statements)

References 132 publications

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“…All women had a routine RM work‐up to identify possible causes of the RM: a standardized history of the couple was performed, karyotyping of the couple (this was offered routinely before 2005 to all couples and after 2005 only in the presence of low maternal age and/or positive family history for RM),15 presence of uterine anomalies by ultrasound or hysteroscopy, and presence of acquired and heritable thrombophilia were assessed. For acquired thrombophilia, antiphospholipid syndrome was defined as the presence of anticardiolipin antibodies or lupus anticoagulant in repeated samples taken 3 months apart and at least 10 weeks after delivery;16 after revision of the classification criteria, the presence of anti‐β2 glycoprotein‐I was added to the work‐up 17. Hyperhomocysteinemia was evaluated.…”

Section: Methodsmentioning

confidence: 99%

Increased cardiovascular disease risk in women with a history of recurrent miscarriage

Wagner

Beshay

Rooijakkers

et al. 2018

Acta Obstet Gynecol Scand

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IntroductionCardiovascular disease is the leading cause of death in women. Observational studies suggest that women with a history of recurrent miscarriage have an increased risk of cardiovascular disease.Material and methodsWomen who visited the recurrent miscarriage clinic at Leiden University Medical Center between 2000 and 2010 and who had their third consecutive miscarriage before the age of 31 years, were invited to participate in this follow‐up study (between 2012 and 2014). The reference group consisted of women with at least one uncomplicated pregnancy and no miscarriage, matched by zip code, age, and date of pregnancy. All women were invited for risk factor screening, including physical examination and blood collection. Main outcome measures were the (extrapolated) 10‐ and 30‐year cardiovascular risk scores using the Framingham risk score. A subanalysis was performed for women with idiopathic recurrent miscarriage.ResultsThirty‐six women were included in both groups. Mean follow up was 7.5 years. Women with recurrent miscarriage had a significantly higher extrapolated 10‐year cardiovascular risk score (mean 6.24%, SD 5.44) compared with women with no miscarriage (mean 3.56%, SD 1.82, P = .007) and a significantly higher 30‐year cardiovascular risk score (mean 9.86%, SD 9.10) compared with women with no miscarriage (mean 6.39%, SD 4.20, P = .04). Similar results were found in women with idiopathic recurrent miscarriage (n = 28).ConclusionsWomen with a history of recurrent miscarriage differ in cardiovascular risk profile at a young age compared with women with no miscarriage. The findings support an opportunity to identify women at risk of cardiovascular disease later in life and a possible moment for intervention.

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Section: Methodsmentioning

confidence: 99%

Increased cardiovascular disease risk in women with a history of recurrent miscarriage

Wagner

Beshay

Rooijakkers

et al. 2018

Acta Obstet Gynecol Scand

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“…The Authors report observing no differences between the results of the two treatments, nor that aPL status predicted vascular occlusive events. There was a great deal of criticisms concerning the study design, and some comments are summarized in JAMA, June 2004 [27] by Cabral et al, Ruiz Irastorza et al, Wahl et al In summary, the mean age of patients was high, no confirmation tests were performed, only 0.2% patients had elevated aCL levels, and many patients were aPL positive (41%), leading to doubts concerning the specificity of the test, and the INR therapeutic target range was unusual and lower than the standard, most often recommended one [2] and [3]. More recently, the risk of ischaemic stroke and of myocardial infarction, has been shown to be very high in young women with lupus anticoagulant, in the RATIO study [28].…”

Section: Intervention Studiesmentioning

confidence: 99%

“…Since Feinstein and Rapaport [1] used the term "lupus anticoagulant" for the first time in 1972, classification criteria for clinical and laboratory diagnosis have been proposed twice: i.e. Wilson et al [2], in 1999 (the so-called "Sapporo" criteria), and the current ones, in 2006, by Miyakis et al [3], (the "Sydney" criteria). These classification criteria have been formulated to allow a well-defined and shared picture of the syndrome.…”

Section: Introductionmentioning

confidence: 99%

Thrombotic recurrences and bleeding events in APS vascular patients: A review from the literature and a comparison with the APS Piedmont Cohort

Bazzan

Vaccarino

Stella

et al. 2013

Autoimmunity Reviews

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In APS vascular patients, thrombotic recurrences are more frequent than in non-APS thrombotic patients. To better define this clinical setting, a systematic review of the literature after 1999 was performed: 8 cohort studies (including the recent APS Piedmont Cohort) and 6 intervention studies were selected and evaluated. Thrombotic recurrences, bleeding events, therapeutic strategies, antiphospholipid (aPL) profile, inherited and acquired risk factors (when present) were calculated and compared. Emerging risk factors for thrombotic recurrences include withdrawal of oral anticoagulant therapy (OAT), high intensity OAT (INR range 3-4), aPL profile (triple positivity, Miyakis types 1 and 2a profiles) and association with inherited or acquired pro-thrombotic risk factors. Moreover, there are evidences that high risk (mainly for aPL profile) APS vascular patients have a high recurrence rate in spite of correct OAT treatment. Clinical trials in this clinical setting are needed.

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“…The antiphospholipid syndrome (APS) is characterized by the presence of antiphospholipid antibodies (aPLA) and clinical manifestations such as recurrent thromboembolic events and/or pregnancy complications [1]. APS may be concomitant with systemic lupus erythematosus (SLE), other autoimmune diseases, malignant diseases and bacterial or viral infections (secondary APS), but may also occur without an underlying disease (primary APS).…”

Section: Introductionmentioning

confidence: 99%

Receptors involved in cell activation by antiphospholipid antibodies

Brandt

Kruithof

Moerloose

2013

Thrombosis Research

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The antiphospholipid syndrome (APS) is an autoimmune disease associated with arterial or venous thrombosis and/or recurrent fetal loss and is caused by pathogenic antiphospholipid antibodies (aPLA). The plasma protein β2-glycoprotein 1 (β2GP1) has been identified as a major target of aPLA associated with APS. Cell activation by aPLA appears to be a major pathogenic cause in the pathogenesis of APS. Receptors, co-receptors and accessory molecules are known to assist the pathogenic effects of aPLA. Members of the TLR family and the platelet receptor apolipoprotein E receptor 2' (apoER2'), a receptor belonging to the low-density lipoprotein receptor (LDL-R) family, as well as GPIbα, were identified as putative candidates for aPLA recognition. CD14, a co-receptor for TLR2 and TLR4, and annexin A2, a ubiquitous Ca2+ -binding protein that is essential for actin-dependent vesicle transport, could serve as important accessory molecules in mediating the pathogenic effects of aPLA. Finally, complement activation has been reported in association with the pathogenicity of APS. The relative contribution of these different mechanisms in the pathogenesis of APS is controversial. Here, we review the various in vivo and in vitro models that have been used to investigate the pathogenic mechanisms of aPLA in APS

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International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS)

Cited by 6,291 publications

References 132 publications

Increased cardiovascular disease risk in women with a history of recurrent miscarriage

Increased cardiovascular disease risk in women with a history of recurrent miscarriage

Thrombotic recurrences and bleeding events in APS vascular patients: A review from the literature and a comparison with the APS Piedmont Cohort

Receptors involved in cell activation by antiphospholipid antibodies

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