Systemic lupus erythematosus in a multiethnic cohort (LUMINA): XXVIII. Factors predictive of thrombotic events

Ho, K. T.; Ahn, Chul; Alarcón, Graciela S.; Baethge, Bruce A.; Tan, Filemon K.; Roseman, Jeffrey M.; Bastian, Holly M.; Fessler, Barri J.; McGwin, Gerald; Vilá, Luis M.; Calvo‐Alén, Jaime; Reveille, John D.

doi:10.1093/rheumatology/kei014

Cited by 122 publications

(74 citation statements)

References 35 publications

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“…These antibodies encompass a heterogeneous group that has been broadly associated with thrombotic events (45)(46)(47), although, in the majority of studies, arterial and venous thrombotic events have been examined together. Our group has found an association between vascular arterial events and the presence of any of the aPL (48), but not when arterial and venous thrombotic events were examined together (49). In addition, it is important to note that our patients were considered positive or negative for IgM and IgG aPL regardless of the antibody titer, whereas the association between these autoantibodies and thrombotic events has been, primarily, with medium and high antibody titers (50).…”

Section: Discussionmentioning

confidence: 85%

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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Section: Discussionmentioning

confidence: 85%

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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“…Its potential antithrombotic mechanisms include inhibition of platelet aggregation and adhesion [18], 6 cholesterol-lowering mechanisms [18] and blockade of aPL production [19].…”

Section: New Oral Anticoagulantsmentioning

confidence: 99%

Targeted therapy in antiphospholipid syndrome

Sciascia

Khamashta

D’Cruz

2014

Current Opinion in Rheumatology

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“…HCQ has been shown to decrease the probability of lupus flares, the accrual of damage, and possibly protect SLE patients from vascular and thrombotic events [181][182][183]. Furthermore, HCQ may facilitate the response to other agents in SLE patients with renal involvement.…”

Section: B Hydroxychloroquinementioning

confidence: 99%

Antiphospholipid Syndrome - An Evolving Story of a Multisystemic Disease

Pierangeli¹,

Harper²,

Harris³

2012

Antiphospholipid Syndrome

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Systemic lupus erythematosus in a multiethnic cohort (LUMINA): XXVIII. Factors predictive of thrombotic events

Abstract: Smoking and disease activity emerged as important determinants in the occurrence of thrombotic events in our patients. Comprehensive treatment strategies should be directed to both smoking cessation and control of disease activity in patients with SLE.

Cited by 122 publications

References 35 publications

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

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

Targeted therapy in antiphospholipid syndrome

Antiphospholipid Syndrome - An Evolving Story of a Multisystemic Disease

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