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Systemic lupus erythematosus in a multiethnic cohort (LUMINA): XXVIII. Factors predictive of thrombotic events
Abstract
OBJECTIVE: To determine the relationship between the presence of antiphospholipid (aPL) antibodies, hydroxychloroquine use and the occurrence of thrombotic events in patients with systemic lupus erythematosus (SLE). METHODS: Four hundred and forty-two SLE patients from the LUMINA (Lupus in Minorities: Nature vs Nurture) cohort, a multiethnic (Hispanics from Texas, n = 99 and Puerto Rico, n = 36; African Americans, n = 172; and Caucasians, n = 135) cohort, were studied by generalized estimating equation (GEE) to determine the relationship between antiphospholipid (aPL) antibodies (measured as IgG and IgM aPL antibodies and/or the lupus anticoagulant) at enrolment or historically prior to enrolment, hydroxychloroquine use (ever) and the occurrence of thrombotic (central and/or peripheral, arterial and/or venous) events after adjusting for known and possible confounders [socioeconomic-demographic features, smoking, disease activity and damage, serum cholesterol levels, anti-oxidized low-density lipoprotein IgG and IgM antibodies, and high-sensitivity (hs) C-reactive protein]. Postanalysis correlation between aPL and anticardiolipin (aCL) assays was attempted by performing aCL assays on random samples of patients whose aPL status was known. RESULTS: A number of clinical variables were significant in the univariable analyses; however, in the multivariable GEE analyses, only smoking [odds ratio (OR) 2.777, 95% confidence interval (CI) 1.317-5.852] and disease activity as measured by the SLAM (Systemic Lupus Activity Measure) (OR 1.099; 95% CI 1.053-1.147) were significant. In particular, hydroxychloroquine use, which appeared to be protective against thrombotic events in the univariable analyses, was not retained in the multivariable analyses. aPL antibodies were not significant in either analysis. Few additional aPL-positive patients emerged from the validation study. CONCLUSIONS: 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.
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“Multiple retrospective and a few prospective studies (3–13) have found that hydroxychloroquine (HCQ) reduces the risk of arterial and venous thrombosis.”
From Association of Higher Hydroxychloroquine Blood Levels With Reduced Thrombosis Risk in Systemic Lupus Erythematosus (2021) · cites this paper as [4]
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Research works printed but not linked: 3
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Metadata
- Authors
- Ho, K. T., Ahn, C. W., Alarcón, G. S., Baethge, B. A., Tan, F. K., Roseman, J., Bastian, H. M., Fessler, B. J., McGwin, G., Vilá, L. M., Calvo-Alén, J., & Reveille, J. D.
- Affiliations
- The University of Texas Health Science Center at Houston (US)
- The University of Texas Medical Branch at Galveston (US)
- University of Alabama at Birmingham (US)
- Corresponding author
- Ho, K. T.
- Venue
- Rheumatology
- Publisher
- Oxford University Press (OUP)
- Published
- 2005-07-19
- Volume
- 44
- Issue
- 10
- Pages
- 1303-1307
- ISSN
- 1462-0324 (ISSN-L)
- 1462-0332
- OpenAlex
- W2165897466
- Cited by
- 128
- References
- 42
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 3 · 2023: 4 · 2022: 4 · 2021: 5 · 2020: 10 · 2019: 5 · 2018: 3 · 2017: 6 · 2016: 7 · 2015: 1 · 2014: 11 · 2013: 11 · 2012: 13
- FWCI
- 3.82
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Lara D. Veeken (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (R01AR042503)
- National Center for Research Resources (P20RR011126, M01RR000032, M01RR002558, M01RR000073)
- Topics
- Health Sciences › Medicine › Rheumatology › Systemic Lupus Erythematosus Research
- Health Sciences › Medicine › Rheumatology › Vasculitis and related conditions
- Health Sciences › Medicine › Hematology › Blood Coagulation and Thrombosis Mechanisms
- Keywords
- systemic lupus erythematosus, thrombotic complications, antiphospholipid antibodies, hydroxychloroquine, smoking, disease activity, lupus anticoagulant, anticardiolipin antibodies, cardiovascular risk factors, multi-ethnic cohort, Hispanic patients, African American patients, smoking cessation, oxidized LDL antibodies
- MeSH terms
- Epidemiologic Methods, Female, Humans, Hydroxychloroquine, Lupus Erythematosus, Systemic, Male, Severity of Illness Index, Smoking, Thrombosis, Antibodies, Antiphospholipid, Antirheumatic Agents
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