Thrombotic Risk Assessment in Systemic Lupus Erythematosus: Validation of the Global Antiphospholipid Syndrome Score in a Prospective Cohort
Open accessAbstract
Objective: This study was performed to prospectively and independently validate the Global Antiphospholipid Syndrome Score (GAPSS), a system derived from the combination of independent risk factors for thrombosis, including antiphospholipid antibodies (aPL) and conventional cardiovascular risk factors. Methods: The GAPSS was applied to 51 consecutive systemic lupus erythematosus patients, all positive for aPL and prospectively followed up for mean ± SD 32.94 ± 12.06 months. Of them, 48 were women with a mean ± SD age of 37.35 ± 12.15 years at entry. The GAPSS was calculated yearly for each patient by adding together the points corresponding to the risk factors. Results: An increase in the GAPSS (entry versus last visit) was seen in patients who experienced vascular events (n = 4, mean ± SD 7.5 ± 4.36 versus 10.0 ± 5.4; P = 0.032). No changes were observed in those without thrombosis (n = 47, mean ± SD 8.28 ± 4.88 versus 7.13 ± 5.75; P = 0.24). An increase in the GAPSS during the followup was associated with a higher risk of vascular events (relative risk 12.30 [95% confidence interval (95% CI) 1.43–106.13], P = 0.004), and an increase of more than 3 points showed the best risk accuracy for vascular events (hazard ratio 48 [95% CI 6.90–333.85], P = 0.0001). The cumulative proportion of thrombosis‐free individuals was lower in patients whose GAPSS was increased by 3 or more points (P = 0.0027). Conclusion: We have prospectively demonstrated that GAPSS is a valid tool for accurate prediction of vascular events in SLE patients with aPL.
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The results are not directly generalizable to other patient groups included in the wide and heterogenic spectrum of APS, such as patients with SLE or patients who are positive for aCL or aβ2-GPI but not LA.
“Consequently, our results are not directly generalizable to other patient groups included in the wide and heterogenic spectrum of APS, such as patients with SLE [34, 38] or patients who are positive for aCL or aβ2-GPI but not LA [39].”
From Cardiovascular risk factors are major determinants of thrombotic risk in patients with the lupus anticoagulant (2017) · cites this paper as [38]
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“Patients with “triple positivity” for aCL, anti- 2GPI, and LA (2), and those with anti- 2GPI, anti-PS/PT, and LAC (3) have been shown to be at a higher risk of developing thromboembolic events.”
BackgroundGAPSS: the Global Anti-Phospholipid Syndrome Score
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Diagnosis and management of the antiphospholipid syndrome
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“Further, a risk score for anamnestic thrombotic risk in patients with SLE, the Global Anti-Phospholipid Syndrome Score (GAPSS), includes two general cardiovascular risk factors: hypertension and hyperlipidemia [34].”
ResultImprovements in diagnosis and risk assessment of primary and secondary antiphospholipid syndrome
Petri, M. (2019) · Hematology · doi:10.1182/hematology.2019000046 · Cited by 11 · see citing works
- Authors
- Sciascia, S., Cuadrado, M. J., Sanna, G., Murru, V., Roccatello, D., Khamashta, M. A., & Bertolaccini, M. L.
- Affiliations
- King's College London (GB)
- St Thomas' Hospital London UK
- St Thomas' Hospital (GB)
- University of Turin (IT)
- King's College London UK
- Venue
- Arthritis Care & Research
- Publisher
- Wiley
- Published
- 2014-11-24
- Volume
- 66
- Issue
- 12
- Pages
- 1915-1920
- ISSN
- 0893-7524 (ISSN-L)
- 2151-464X
- 2151-4658
- OpenAlex
- W1578529971
- Cited by
- 55
- References
- 21
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 3 · 2022: 6 · 2021: 3 · 2020: 7 · 2019: 6 · 2018: 8 · 2017: 11 · 2016: 5 · 2015: 4
- FWCI
- 5.53
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Arthritis Care & Research (publishedVersion)
- PubMed (publishedVersion)
- Institutional Research Information System University of Turin (University of Turin) (submittedVersion, other-oa)
- Research Portal (King's College London) (submittedVersion)
- Topics
- Health Sciences › Medicine › Rheumatology › Systemic Lupus Erythematosus Research
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Vasculitis and related conditions
- Health Sciences › Medicine › Hematology › Blood Coagulation and Thrombosis Mechanisms
- Keywords
- systemic lupus erythematosus, antiphospholipid syndrome, thrombotic risk assessment, antiphospholipid antibodies, vascular events, cardiovascular risk factors, risk score validation, thrombosis prediction
- MeSH terms
- Adult, Female, Humans, Lupus Erythematosus, Systemic, Male, Middle Aged, Prospective Studies, Thrombosis, Antibodies, Antiphospholipid, Risk Assessment
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