Incidence of a first thromboembolic event in carriers of isolated lupus anticoagulant
Abstract
Among the so called antiphospholipid (aPL) antibodies Lupus Anticoagulant (LAC) is considered the strongest risk factor for thromboembolic events. In individuals without a previous thromboembolic event (carriers), LAC is a risk factor when associated with the presence of anticardiolipin (aCL) and aβ2-Glycoprotein I (aβ2GPI) antibodies. On the other hand, data on carriers of isolated LAC positivity are sparse and inconclusive. The aim of this study was to prospectively determine the incidence of thrombosis in a cohort of carriers of isolated LAC positivity. One-hundred seventy-nine carriers of LAC confirmed twelve weeks apart and in a reference laboratory were studied. During a total follow up of 552 person-years, there were seven thromboembolic events (1.3% person-y). All the seven patients had at least one adjunctive major risk factor for thrombosis. The cumulative incidence of thromboembolic events was 3.1% (95% CI 0.6-5.6) after 2years, and 5.9% (95% CI 1.2-10.6) after 5 and 10years. On a multivariate regression analysis considering age, sex, autoimmune disease, risk factors for arterial and venous thrombosis, use of aspirin, only age was found to be an independent predictor of thromboembolic events (HR=1.1, 95% CI 1.0-1.2, p=0.02). These data might be relevant in clinical practice and underline the importance of differentiating LAC carriers in terms of isolated positivity or positivity associated with the presence of antibodies to aCL and β2-glycoprotein I.
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While triple positivity has been shown to be a significant thrombotic risk factor in the WAPS study, several more recent prospective cohorts have also observed a lack of association between triple positivity or other LA-related autoantibodies and thrombosis.
“While triple positivity has been shown to be a significant thrombotic risk factor in the WAPS study [7], several more recent prospective cohorts have also observed a lack of association between triple positivity or other LA-related autoantibodies and thrombosis [30, 32, 33].”
From Cardiovascular risk factors are major determinants of thrombotic risk in patients with the lupus anticoagulant (2017) · cites this paper as [30]
These results confirm and validate several previous reports that have implicated these antibodies in the pathogenesis of APS.
“These results confirm and validate several previous reports that have implicated these antibodies in the pathogenesis of APS [9, 10, 12, 13, 29, 30], but they also add to the growing body of evidence that shows inconsistent associations between aPL-associated autoantibodies and anamnestic thrombotic risk [3, 16].”
From Cardiovascular risk factors are major determinants of thrombotic risk in patients with the lupus anticoagulant (2017) · cites this paper as [30]
It is generally accepted that patients with isolated LAC have a lower risk profile in APS.
“It is generally accepted that patients with isolated LAC have alowerriskprofileinAPS 12,20”
From Clinical Relevance of Isolated Lupus Anticoagulant Positivity in Patients with Thrombotic Antiphospholipid Syndrome (2021) · cites this paper as [12]
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- Authors
- Pengo, V., Testa, S., Martinelli, I., Ghirarduzzi, A., Legnani, C., Gresele, P., Passamonti, S. M., Bison, E., Denas, G., Jose, S. P., Banzato, A., & Ruffatti, A.
- Affiliations
- University of Padua (IT)
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico (IT)
- Santa Maria Nuova Hospital (IT)
- University of Bologna (IT)
- University of Perugia (IT)
- Corresponding author
- Pengo, Vittorio
- ORCID
- Venue
- Thrombosis Research
- Publisher
- Elsevier BV
- Published
- 2015-01
- Volume
- 135
- Issue
- 1
- Pages
- 46-49
- ISSN
- 0049-3848 (ISSN-L)
- OpenAlex
- W2070626622
- Cited by
- 89
- References
- 30
- Citations by year
- 2026: 5 · 2025: 5 · 2024: 7 · 2023: 4 · 2022: 10 · 2021: 7 · 2020: 13 · 2019: 5 · 2018: 15 · 2017: 6 · 2016: 9 · 2015: 3
- FWCI
- 4.99
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Thrombosis Research (publishedVersion)
- PubMed (publishedVersion)
- Padua Research Archive (University of Padova) (submittedVersion)
- 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
- lupus anticoagulant, thromboembolic events, thrombosis incidence, antiphospholipid antibodies, anticardiolipin antibodies, anti-beta2-glycoprotein I antibodies, thrombosis risk factors, age as predictor, aspirin
- MeSH terms
- Adult, Aged, Antibodies, Female, Humans, Male, Middle Aged, Prospective Studies, Risk Factors, Thromboembolism, Thrombosis, Time Factors, Incidence, Multivariate Analysis, Lupus Coagulation Inhibitor, Treatment Outcome, Antibodies, Anticardiolipin, beta 2-Glycoprotein I
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