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A Retrospective Review of 61 Patients With Antiphospholipid Syndrome: Analysis of Factors Influencing Recurrent Thrombosis
Abstract
Background: Antiphospholipid syndrome (APS) is a disorder of recurrent venous or arterial thrombosis, pregnancy losses, and thrombocytopenia. Recurrent thrombosis has particularly adverse effects on patient prognosis. The factors that influence recurrence and management techniques that prevent these events remain controversial. To add further insight regarding predisposing factors and the prevention of thrombotic recurrence, 61 wellcharacterized patients with APS were followed up for a median time of 77 months. Methods: A retrospective cohort study was conducted in which the following factors were examined to determine their influence on thrombotic recurrence: primary vs secondary syndrome; the presence of hypertension, hyperlipidemia, diabetes, or smoking; patient age, sex, and race; pregnancy and oral contraceptives use; and treatment with warfarin sodium, warfarin plus aspirin, aspirin alone, prednisone, or no treatment. Results: There was no difference between patients with primary and secondary APS with respect to recurrent arterial (55% vs 38%, respectively) or recurrent venous (47% vs 50%, respectively) thrombotic events. In all patients with APS, white race (P=.02) was associated with recurrent arterial events. Venous thrombosis occurred during pregnancy or in the postpartum period in 16 (30%) of 53 women and in 8 women taking oral contraceptives. Recurrent arterial and venous thromboses were significantly decreased with prophylactic warfarin use when compared with prednisone use or no treatment. Recurrences were infrequent in patients with prothrombin ratios of 1.5 to 2.0. Conclusions: Treatment with warfarin was most effective in preventing recurrent arterial and venous thrombosis. Pregnancy and the use of oral contraceptives or prednisone may also influence recurrence. Arch Intern Med. 1997;157:2101-2108
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From EULAR recommendations for the management of antiphospholipid syndrome in adults (2019) · cites this paper as [36]
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“In this study, there was a significant decrease in recurrence among patients on warfarin alone as well as warfarin with LDA; additionally, there were no recurrent arterial events at all among patients on warfarin with LDA, but the difference between the groups with and without LDA was not significant because of an ins…”
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Treatment of antiphospholipid antibody syndrome
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The Antiphospholipid Syndrome: Clinical Presentation, Diagnosis, and Patient Management
Rand, J. H., Levin, M. B., & Alving, B. M. (2007) · Elsevier eBooks · doi:10.1016/b978-141602401-9.10019-7 · Cited by 4
Yang, W., Chung, M. J., Ha, J., Kang, D., Lee, E., Jeong, H., Kim, J., Jung, K., & Lee, S. (2025) · Scientific Reports · doi:10.1038/s41598-025-91739-w · Cited by 3
“The studies that currently serve as references supporting the use of warfarin were conducted 20–30 years ago 12–15 , and they may be susceptible to selection bias due to the challenges in diagnosing minor strokes during that period.”
Rand, J. H., & Wolgast, L. R. (2013) · Elsevier eBooks · doi:10.1016/b978-1-4557-2296-9.00020-8 · Cited by 3
Pengo, V., Zocche, A., Scognamiglio, R., Biasiolo, A., Roš, T., & Ruffatti, A. (2001) · Elsevier eBooks · doi:10.1016/b978-044450669-6/50034-7 · Cited by 3
Tratamiento del síndrome antifosfolipídico, ¿a quién, cuándo y cuánto tiempo?
Castañeda, M. C. A. (2005) · Reumatología Clínica · doi:10.1016/s1699-258x(05)72773-x · Cited by 2
Antiphospholipid antibody syndrome—an overview
Sridevi, C., & Raju, P. K. (2011) · Journal of Indian College of Cardiology · doi:10.1016/s1561-8811(11)80022-2 · Cited by 2
Management of the antiphospholipid syndrome: new approaches
Seif, A. M., Hwang, Y. G., & Pierangeli, S. S. (2009) · International Journal of Clinical Rheumatology · doi:10.2217/ijr.09.43 · Cited by 2
Metadata
- Authors
- Krnic-Barrie, S.
- Corresponding author
- Krnic-Barrie, Sanja
- Venue
- Archives of Internal Medicine
- Publisher
- American Medical Association (AMA)
- Published
- 1997-10-13
- Volume
- 157
- Issue
- 18
- Pages
- 2101
- ISSN
- 0003-9926 (ISSN-L)
- OpenAlex
- W4253029803
- Cited by
- 134
- References
- 0
- Citations by year
- 2025: 5 · 2024: 1 · 2023: 1 · 2022: 2 · 2021: 2 · 2020: 3 · 2019: 5 · 2018: 2 · 2017: 4 · 2016: 1 · 2015: 3 · 2014: 4 · 2013: 1 · 2012: 5
- FWCI
- 4.95
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Internal Medicine (publishedVersion)
- Funders
- Fogarty International Center (1 FO5 TWO 4936-01)
- Topics
- Health Sciences › Medicine › Rheumatology › Systemic Lupus Erythematosus Research
- Health Sciences › Medicine › Hematology › Blood Coagulation and Thrombosis Mechanisms
- Health Sciences › Medicine › Internal Medicine › Venous Thromboembolism Diagnosis and Management
- Keywords
- antiphospholipid syndrome, recurrent thrombosis, venous thrombosis, arterial thrombosis, warfarin prophylaxis, prednisone, oral contraceptives, pregnancy, prothrombin ratio, risk factors, anticoagulation
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