Risk for venous thrombosis related to antiphospholipid antibodies in systemic lupus erythematosus—A meta-analysis

Wahl, D.; Guillemin, Françis; Maistre, Emmanuel de; Perret, C.; Lecompte, T.; Thibaut, G

doi:10.1177/096120339700600510

Cited by 261 publications

(131 citation statements)

References 22 publications

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“…For the first time, we believe, EMPs are in evidence in normal human plasma and are found to be increased in patients selected according to a biological abnormality, namely being positive for LA. This coagulation abnormality is well recognized to be strongly associated with a thrombotic tendency (31,32). This association has been termed antiphospholipid syndrome (APS).…”

Section: Figurementioning

confidence: 99%

In vitro generation of endothelial microparticles and possible prothrombotic activity in patients with lupus anticoagulant

Combes¹,

Simon²,

Grau³

et al. 1999

J. Clin. Invest.

684

666

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Section: Figurementioning

confidence: 99%

In vitro generation of endothelial microparticles and possible prothrombotic activity in patients with lupus anticoagulant

Combes¹,

Simon²,

Grau³

et al. 1999

J. Clin. Invest.

684

666

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“…Any information about authors, journals, and institutions was deleted for the purpose of quality assessment. The scoring system was adapted from the meta-analyses by Wahl et al 5,6 The quality assessment form encompassed 64 items distributed in 4 categories: clinical criteria (SLE patients classified or not according to the American College of Rheumatology classification 15,16 and measure of disease activity); echocardiographic diagnosis of the outcome (HVD) 7 ; definition of the exposure to aPL 7,[17][18][19][20] ; and statistical analysis and control for confounders. Finally, a score was obtained for each category for all studies.…”

Section: Quality Assessmentmentioning

confidence: 99%

“…A ntiphospholipid antibodies (aPL) may be considered either as risk factors for arterial or venous thrombosis as well as recurrent fetal losses [1][2][3][4][5][6] or as markers of the so-called antiphospholipid syndrome (APS). APS is characterized by venous or arterial thromboses and obstetric morbidity associated with persistent aPL according to the classification criteria.…”

mentioning

confidence: 99%

Increased Risk for Heart Valve Disease Associated With Antiphospholipid Antibodies in Patients With Systemic Lupus Erythematosus

Zuily¹,

Régnault²,

Selton-Suty³

et al. 2011

Circulation

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156

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Background-Heart valve disease (HVD) is frequent in patients with systemic lupus erythematosus (SLE), and the role of antiphospholipid antibodies (aPL) is controversial. Thus, our objective was to estimate the risk of HVD, including Libman-Sacks endocarditis, associated with aPL in patients with SLE. Methods and Results-Studies were selected if they investigated the association between aPL and HVD in SLE patients and if aPL-negative patients were included for comparison. Data sources were MEDLINE, Embase, Cochrane Library, hand search, contact with investigators, and reference lists of studies, without language restrictions. Data on study and patient characteristics, risk estimates, and study quality were independently extracted by 2 investigators. Pooled effect estimates were obtained by using the DerSimonian-Laird method. Of 234 identified abstracts, 23 primary studies (15 cross-sectional, 7 cohort, 1 case-control) met inclusion criteria, including 1656 SLE patients and 508 cases of HVD. Compared with SLE patients without aPL (nϭ988), the overall pooled odds ratios for HVD and Libman-Sacks endocarditis in aPL-positive patients (nϭ668) were 3.13 (95% confidence interval, 2.31 to 4.24) and 3.51 (95% confidence interval, 1.93 to 6.38), respectively. The risk of HVD depending on aPL subtypes was the highest for lupus anticoagulant at 5.

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“…The association of venous thrombosis with antiphospholipid antibodies (aPL) (IgG and IgM anticardiolipin antibodies and lupus anticoagulant [LAC]) has been well established; this has been observed in patients without an underlying autoimmune disease (3), but has particularly been found in patients with SLE (4). The association has been primarily identified in retrospective studies; more recently, a systematic review, a meta-analysis, and a prospective study have confirmed this association (2,4,5).…”

mentioning

confidence: 99%

Systemic lupus erythematosus in a multiethnic US cohort (LUMINA): XXV. Smoking, older age, disease activity, lupus anticoagulant, and glucocorticoid dose as risk factors for the occurrence of venous thrombosis in lupus patients

Calvo‐Alén

Toloza

Fernández

et al. 2005

Arthritis & Rheumatism

127

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Objective. Venous thrombosis is a relatively frequent and serious complication in systemic lupus erythematosus (SLE) that has been associated with the presence of antiphospholipid antibodies (aPL). However, venous thrombotic events can also be seen in patients without aPL, and only a few patients with aPL develop venous thrombosis. This study was carried out to ascertain other factors contributing to the development of venous thrombosis in SLE.Methods. Patients with SLE, ages >16 years with <5 years disease duration and of Hispanic, African American, or Caucasian ethnicity, from LUMINA (LUpus in MInorities, NAture versus nurture), a multiethnic, longitudinal study of outcome, were studied. Selected socioeconomic/demographic, clinical, laboratory, and treatment-exposure variables were compared between patients who developed and those who did not develop venous thrombotic events. Significant and clinically relevant variables were then entered into different multivariable models (Cox proportional hazards and unconditional stepwise logistic regression) to identify independent risk factors associated with the primary outcome. In another model, only patients who developed an event after enrollment (time 0) in the cohort were included.Results. Of 570 LUMINA patients, 51 developed at least 1 venous thrombotic event after SLE diagnosis. In univariable analyses, smoking (P ‫؍‬ 0.020), shorter disease duration at time 0 (P ‫؍‬ 0.017), serum levels of total cholesterol, low-density lipoprotein, and triglycerides (all P < 0.0001), and presence of lupus anticoagulant (LAC) (P ‫؍‬ 0.045) were associated with venous thrombotic events. Survival analyses showed a timedependent significant association of the primary outcome with smoking (P ‫؍‬ 0.008) and a borderline significant association with the presence of LAC (P ‫؍‬ 0.070). Multivariable models showed an independent association with smoking, age at time 0, disease activity over time, LAC, mean dose of glucocorticoids, and shorter disease duration at time 0.Conclusion. Venous thrombotic events occur early in the course of SLE. Our data confirm the association between LAC and venous thrombotic events. Smoking, shorter disease duration, older age, disease activity over

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Risk for venous thrombosis related to antiphospholipid antibodies in systemic lupus erythematosus—A meta-analysis

Cited by 261 publications

References 22 publications

In vitro generation of endothelial microparticles and possible prothrombotic activity in patients with lupus anticoagulant

In vitro generation of endothelial microparticles and possible prothrombotic activity in patients with lupus anticoagulant

Increased Risk for Heart Valve Disease Associated With Antiphospholipid Antibodies in Patients With Systemic Lupus Erythematosus

Systemic lupus erythematosus in a multiethnic US cohort (LUMINA): XXV. Smoking, older age, disease activity, lupus anticoagulant, and glucocorticoid dose as risk factors for the occurrence of venous thrombosis in lupus patients

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