Cited by 497Venous Thromboembolism Diagnosis and ManagementSystemic Lupus Erythematosus ResearchBlood Coagulation and Thrombosis Mechanisms

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Anticardiolipin Antibodies Predict Early Recurrence of Thromboembolism and Death Among Patients with Venous Thromboembolism Following Anticoagulant Therapy

Schulman, Sam, Svenungsson, Elisabet, Granqvist, Staffan·1998·The American Journal of Medicine

DOI 10.1016/s0002-9343(98)00060-6

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Abstract

Purpose To compare the risk of recurrent venous thromboembolism in patients with and without antiphospholipid antibodies.Patients and methods Anticardiolipin antibodies were tested 6 months after a first or second episode of venous thromboembolism. Of the patients with a first episode of venous thromboembolism only the 412 who received 6 months of anticoagulation were studied. Two hundred and eleven patients with a second episode received oral anticoagulation for 6 months or indefinitely. The therapy was targeted at an international normalized ratio (INR) of 2.0 to 2.85. All patients were followed up for 4 years after enrollment.Results Among the 412 patients with a first episode of venous thromboembolism the risk of recurrence was 29% in patients with anticardiolipin antibodies and 14% in those without antibodies (P = 0.0013). In those with antibodies, there was an increased risk during the first 6 months after cessation of anticoagulation. The risk of recurrence increased with the titer of the antibodies. Four-year mortality rate was 15% in those with antibodies and 6% in those without (P = 0.01). Among 34 patients with a second event of venous thromboembolism and anticardiolipin antibodies, there were no recurrences during anticoagulant therapy versus 20% in those who received only 6 months of treatment (P = 0.08).Conclusions The presence of elevated titers of anticardiolipin antibodies 6 months after an episode of venous thromboembolism is a predictor for an increased risk of recurrence and of death. Patients with anticardiolipin antibodies and venous thromboembolism seem to benefit from prolonged oral anticoagulation.

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Authors: Schulman, S., Svenungsson, E., & Granqvist, S.
Affiliations: Karolinska University Hospital (SE)
Ersta sjukhus (SE)
Corresponding author: Schulman, Sam
ORCID: Schulman, Sam
Svenungsson, Elisabet
Venue: The American Journal of Medicine
Publisher: Elsevier BV
Published: 1998-04
Volume: 104
Issue: 4
Pages: 332-338
ISSN: 0002-9343 (ISSN-L)
DOI: 10.1016/s0002-9343(98)00060-6
OpenAlex: W2152900444
Cited by: 497
References: 24
Citations by year: 2026: 3 · 2025: 3 · 2024: 9 · 2023: 6 · 2022: 4 · 2021: 5 · 2020: 10 · 2019: 13 · 2018: 9 · 2017: 10 · 2016: 13 · 2015: 8 · 2014: 9 · 2013: 18 · 2012: 21
FWCI: 19.61
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: The American Journal of Medicine (publishedVersion)
PubMed (publishedVersion)
Funders: Hjärt-Lungfonden
Karolinska Institutet
Topics: Health Sciences › Medicine › Internal Medicine › Venous Thromboembolism Diagnosis and Management
Health Sciences › Medicine › Rheumatology › Systemic Lupus Erythematosus Research
Health Sciences › Medicine › Hematology › Blood Coagulation and Thrombosis Mechanisms
Keywords: anticardiolipin antibodies, antiphospholipid antibodies, venous thromboembolism, thromboembolism recurrence, oral anticoagulation, long-term anticoagulation, mortality, antibody titers, international normalized ratio
MeSH terms: Aged, Anticoagulants, Cause of Death, Female, Follow-Up Studies, Humans, Male, Middle Aged, Prognosis, Recurrence, Risk, Thromboembolism, Antibodies, Anticardiolipin

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Anticardiolipin Antibodies Predict Early Recurrence of Thromboembolism and Death Among Patients with Venous Thromboembolism Following Anticoagulant Therapy

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