The DOI matches its Crossref record; 41 of the 41 references it cites were found in a registry or an index; 3 of the 23 sources its claims cite were checked for support.
Clinical course of high‐risk patients diagnosed with antiphospholipid syndrome
Open accessAbstract
Background The characteristics and the clinical course of antiphospholipid syndrome (APS) in high-risk patients that are positive for all three recommended tests that detect the presence of antiphospholipid (aPL) antibodies have not been described. Methods This retrospective analysis of prospectively collected data examined patients referred to Italian Thrombosis Centers that were diagnosed with definite APS and tested positive for aPL [lupus anticoagulant (LA), anti-cardiolipin (aCL), and anti-beta2-glycoprotein I (beta2GPI) antibodies]. Laboratory data were confirmed in a central reference laboratory. Results One hundred and sixty patients were enrolled in this cohort study. The qualifying events at diagnosis were venous thromboembolism (76 cases; 47.5%), arterial thromboembolism (69 cases; 43.1%) and pregnancy morbidity (11 cases; 9.7%). The remaining four patients (2.5%) suffered from catastrophic APS. The cumulative incidence of thromboembolic events in the follow-up period was 12.2% (95% CI, 9.6-14.8) after 1 year, 26.1% (95% CI, 22.3-29.9) after 5 years and 44.2% (95% CI, 38.6-49.8) after 10 years. This was significantly higher in those patients not taking oral anticoagulants as compared with those on treatment (HR=2.4 95% CI 1.3-4.1; P<0.003). Major bleeding associated with oral anticoagulant therapy was low (0.8% patient/years). Ten patients died (seven were cardiovascular deaths). Conclusions Patients with APS and triple positivity for aPL are at high risk of developing future thromboembolic events. Recurrence remains frequent despite the use of oral anticoagulants, which significantly reduces the risk of thromboembolism.
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TL;DR
In 160 patients with definite antiphospholipid syndrome (APS) and triple positivity for lupus anticoagulant, anti-cardiolipin, and anti-β2-glycoprotein I antibodies, thromboembolic recurrence was frequent, with a cumulative incidence of 44.2% at 10 years. Oral anticoagulant treatment was associated with a significantly lower risk of recurrent thromboembolism, while major bleeding on anticoagulation was low.
Key findings
- During follow-up, 55 of 160 patients (34.4%) had a thromboembolic event (25 venous, 30 arterial); cumulative incidence was 12.2% (95% CI 9.6–14.8) at 1 year, 26.1% (95% CI 22.3–29.9) at 5 years, and 44.2% (95% CI 38.6–49.8) at 10 years.
- Oral anticoagulant status was the only predictor of thromboembolic events in multivariate Cox analysis: events occurred in 36/123 anticoagulated patients versus 19/37 non-anticoagulated patients, with HR 2.4 (95% CI 1.3–4.1; P < 0.003) for not taking oral anticoagulants; cumulative incidence was significantly higher in untreated patients (P = 0.002).
- Major bleeding was low: 8 major bleeding events, 7 in patients on oral anticoagulants (0.8% patient/years); there were 10 deaths (0.8% patients/years; 7 cardiovascular, 3 non-cardiovascular).
- Recurrence did not depend on the qualifying event: 10-year cumulative incidence was 45% for venous, 47% for arterial, and 37% for pregnancy morbidity as the qualifying event (P = ns).
Methods
- Retrospective analysis of prospectively collected data from Italian Thrombosis Centers, including 160 patients with definite APS and triple positivity for LA, aCL, and anti-β2GPI antibodies, confirmed in a central reference laboratory; inclusion required LA and anti-β2GPI positivity and aCL > 40 GPL and/or > 40 MPL units.
- Observation period from earliest diagnosis (March 1989) to March 2009; outcomes included objectively diagnosed thromboembolic events, major bleeding, and death.
- Kaplan-Meier survival analysis estimated cumulative incidence of thromboembolic events; log-rank tests compared groups; Cox regression identified predictors of the primary endpoint.
Limitations
- The paper does not include a formal limitations section; evident limitations include the observational, non-randomized treatment comparison (123 patients received long-term oral anticoagulants versus 37 who did not), so treatment effects may be confounded.
- The cohort was selected from Thrombosis Centers and restricted to triple-positive APS patients with aCL > 40 units, limiting generalizability to other APS laboratory profiles or lower-risk populations.
- Follow-up attrition was substantial: only 23 patients (14.4%) completed 10 years; pregnancy morbidity was uncommon (11 cases), and the reported percentage differs between the abstract (9.7%) and Results/Table 1 (6.9%).
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Claims the paper makes
24 Own result · 11 No full text of the sources · 6 Own interpretation · 4 Own method · 3 Sources not found · 1 Supported so far · 1 Partly supported · 1 Couldn’t confirm · 1 Not checked yet · accuracy not yet measured
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“This selected cohort of patients differed from the large cohort described by Cervera et al. [25,26] in several aspects.”
§ Clinical course of high-risk patients diagnosed with antiphospholipid syndrome > Discussion
What the sources say
- Not checked — no full text of the sourcecites [25] source
- Supportedcites [26] source
The Patient selection section describes a multicentre cohort of 1,000 unselected patients with antiphospholipid syndrome. The citation identifies the large Cervera et al. cohort used for comparison; the assertion that the citing authors’ cohort differs is their own comparison. (LLM, conf=0.90)
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“As there is currently no evidence to support the superiority of oral anticoagulant therapy over antiplatelet therapy [15], antiplatelet drugs are generally recommended after an episode of stroke.”
§ Clinical course of high-risk patients diagnosed with antiphospholipid syndrome > Discussion
What the sources say
- Partly supportedcites [15] sourceExperimental — accuracy not yet measured
The COMMENT section reports that warfarin was not associated with fewer thrombo-occlusive events than aspirin in the studied stroke cohort. That supports the comparison, but the citing sentence generalizes it to all oral anticoagulants and antiplatelet therapies; the paper does not establish that broader claim. No page number is available in the supplied copy. (LLM, conf=0.85)
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The cited sources that could be checked couldn’t confirm or dispute this claim.
In the paper
“Less than half of the patients reported by Cervera et al. were LA positive.”
§ Clinical course of high-risk patients diagnosed with antiphospholipid syndrome > Discussion
What the sources say
- Not checked — no full text of the sourcecites [25] source
- Could not verifycites [26] sourceExperimental — accuracy not yet measured
The Laboratory studies section says LA activity was tested but gives no positivity rate. The General characteristics section says the cohort’s immunological findings were reported elsewhere. Searches for LA prevalence and a percentage below 50% found no figure in our copy (page numbers unavailable). (LLM, conf=0.75)
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“The remaining four patients (2.5%) suffered from catastrophic APS.”
§ Clinical course of high-risk patients diagnosed with antiphospholipid syndrome > Abstract
plainn = 4- Asserted: passes — The authors put it forward as true.
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In the paper
“Major bleeding associated with oral anticoagulant therapy was low (0.8% patient/years).”
§ Clinical course of high-risk patients diagnosed with antiphospholipid syndrome > Abstract
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Our data come close to the data from Cervera et al., if we only considered primary APS patients (female/male ratio drops to 3.5:1) [25].”
§ Clinical course of high-risk patients diagnosed with antiphospholipid syndrome > Discussion
What the sources say
- Not checked — no full text of the sourcecites [25] source
hedged- Asserted: passes — The authors put it forward as true.
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A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“Our findings do not confirm the findings of previous studies [23,27] that have suggested that the recurrence of an event is more likely to occur in the same vascular district (i.e.venous or arterial).”
§ Clinical course of high-risk patients diagnosed with antiphospholipid syndrome > Discussion
What the sources say
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“The qualifying event at diagnosis was VTE in 76 cases (47.5%), arterial thromboembolism in 69 cases (43.1%) and pregnancy morbidity in 11 cases (6.9%).”
§ Clinical course of high-risk patients diagnosed with antiphospholipid syndrome > Results
plainn = 69- Asserted: passes — The authors put it forward as true.
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In the paper
“The qualifying event at diagnosis did not predict the type of recurrence (arterial or venous).”
- Also stated in: § Thromboembolic events during the followup period · plain
“The incidence of events during follow-up was independent of the clinical manifestations at diagnosis.”
§ Clinical course of high-risk patients diagnosed with antiphospholipid syndrome > Discussion
plainn = 160- Asserted: passes — The authors put it forward as true.
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- Also stated in: § Thromboembolic events during the followup period · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The cumulative incidence of thromboembolic events in the follow-up period was 12.2% (95%CI, 9.6-14.8)after 1 year, 26.1% (95%CI, 22.3-29.9)after 5 years and 44.2% (95%CI, 38.6-49.8)after 10 years.”
§ Clinical course of high-risk patients diagnosed with antiphospholipid syndrome > Abstract
plain- Asserted: passes — The authors put it forward as true.
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- The quote only partly states this claim. 3
- It may state two separate claims as one. 17
- Probably not a substantial claim. 6
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“One hundred and sixty patients were enrolled in this cohort study.”
- Also stated in: § Results · plain
“Thus, 160 patients with three positive APS tests were enrolled in this cohort study.”
§ Clinical course of high-risk patients diagnosed with antiphospholipid syndrome > Abstract
plainn = 160- Asserted: passes — The authors put it forward as true.
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- Also stated in: § Results · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Ten patients died (seven were cardiovascular deaths).”
§ Clinical course of high-risk patients diagnosed with antiphospholipid syndrome > Abstract
plainn = 10- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The qualifying event at diagnosis was VTE in 76 cases (47.5%), arterial thromboembolism in 69 cases (43.1%) and pregnancy morbidity in 11 cases (6.9%).”
- Also stated in: § Abstract · plain
“The qualifying events at diagnosis were venous thromboembolism (76 cases; 47.5%), arterial thromboembolism (69 cases; 43.1%) and pregnancy morbidity (11 cases; 9.7%).”
§ Clinical course of high-risk patients diagnosed with antiphospholipid syndrome > Results
plainn = 11- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Also stated in: § Abstract · plain
In the paper
“We had more male patients (29% vs. 18%) and primary APS cases (62% vs. 53%).”
§ Clinical course of high-risk patients diagnosed with antiphospholipid syndrome > Discussion
What the sources say
- Not checked — no full text of the sourcecites [25] source
plain- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
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In the paper
“The number of enrolled patients with obstetric complications alone was low (9.7%), highlighting that the majority of female patients with triple positivity in laboratory tests suffer from thromboembolic events [22].”
§ Clinical course of high-risk patients diagnosed with antiphospholipid syndrome > Discussion
plain- Asserted: passes — The authors put it forward as true.
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The quote only partly states this claim.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“There were eight major bleeding events -seven in patients on oral anticoagulants (0.8% patient/years) -and 10 deaths during follow-up (0.8% patients/years; seven were cardiovascular and three were non-cardiovascular deaths).”
§ Clinical course of high-risk patients diagnosed with antiphospholipid syndrome > Major bleeding and death
plain- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“As shown in Fig. 2, the cumulative incidence of events after 10 years was 45%, 47% and 37% for venous, arterial and pregnancy morbidity as a qualifying event, respectively (P = ns).”
§ Clinical course of high-risk patients diagnosed with antiphospholipid syndrome > Thromboembolic events during the followup period
plain- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Out of the 160 patients, 55 (34.4%) had a thromboembolic event during the follow-up period; 25 were VTE and 30 were arterial thromboembolism.”
§ Clinical course of high-risk patients diagnosed with antiphospholipid syndrome > Thromboembolic events during the followup period
plainn = 160- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Of the 189 patients considered for this study, 29 were excluded; 11 because the laboratory data were not confirmed in the reference laboratory and 18 for having both GPL and MPL aCL titers of < 40 units.”
§ Clinical course of high-risk patients diagnosed with antiphospholipid syndrome > Results
plainn = 189- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Subsequent thromboembolism occurred in 36 (16 VTE and 20 ATE) out of 123 anticoagulated patients [median International normalized ratio (INR) at the time of event 2.3], and in 19 (9 VTE and 10 ATE) out of the 37 non-anticoagulated patients.”
§ Clinical course of high-risk patients diagnosed with antiphospholipid syndrome > Thromboembolic events during the followup period
plainn = 123- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“There were eight major bleeding events -seven in patients on oral anticoagulants (0.8% patient/years) -and 10 deaths during follow-up (0.8% patients/years; seven were cardiovascular and three were non-cardiovascular deaths).”
§ Clinical course of high-risk patients diagnosed with antiphospholipid syndrome > Major bleeding and death
plainn = 7- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Out of 160 patients, 123 received long-term oral anticoagulant treatment during the entire follow-up period, whereas 37 did not (13 did not take anticoagulants and 24 took aspirin alone).”
§ Clinical course of high-risk patients diagnosed with antiphospholipid syndrome > Thromboembolic events during the followup period
plainn = 160- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“One hundred and thirty-one (81.9%) patients completed the 1year follow-up, 76 (47.5%) completed 5 years and 23 (14.4%) completed 10 years of follow-up.”
§ Clinical course of high-risk patients diagnosed with antiphospholipid syndrome > Thromboembolic events during the followup period
plainn = 160- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Mean follow-up was 6.0 (± 4.6) years (range 0.3-20 years).”
§ Clinical course of high-risk patients diagnosed with antiphospholipid syndrome > Thromboembolic events during the followup period
plainn = 160- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Many clinical studies on APS have included patients with different laboratory profiles, and consequently, the results may lack consistency [14][15][16][17].”
§ Clinical course of high-risk patients diagnosed with antiphospholipid syndrome > Introduction
What the sources say
- Not matchedcites [14][15][16][17]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
hedgedconditional- Asserted: passes — The authors put it forward as true.
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- Not matched
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“As just one positive test is sufficient for APS diagnosis, there is a substantial risk of diagnosing APS in patients with either one false-positive test or with antibodies that recognize a target that is irrelevant to the syndrome.”
§ Clinical course of high-risk patients diagnosed with antiphospholipid syndrome > Introduction
plaindirect- Asserted: passes — The authors put it forward as true.
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None of the sources cited for this claim have been checked yet.
In the paper
“Oral anticoagulants are recommended after a first episode of VTE [28] to prevent recurrence [29][30][31][32].”
§ Clinical course of high-risk patients diagnosed with antiphospholipid syndrome > Discussion
What the sources say
- Not checked — no full text of the sourcecites [28] source
- Not matchedcites [29][30][31][32]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaindirect- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“To confirm triple positivity for aPL, and to validate the laboratory diagnosis, patient plasma from each center was also tested in a reference laboratory.”
§ Clinical course of high-risk patients diagnosed with antiphospholipid syndrome > Study design and population
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. It may state two separate claims as one.
In the paper
“However, these tests are poorly standardized, which leads to low sensitivity [2][3][4].”
§ Clinical course of high-risk patients diagnosed with antiphospholipid syndrome > Introduction
What the sources say
- Not matchedcites [2][3][4]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaindirect- Asserted: passes — The authors put it forward as true.
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- Not matched
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Importantly, data were confirmed in all patients and tests were repeated in recurrent cases or each year in the majority of patients.”
§ Clinical course of high-risk patients diagnosed with antiphospholipid syndrome > Discussion
plain- Asserted: passes — The authors put it forward as true.
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What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Both the type and site of any thromboembolic events at diagnosis were demonstrated objectively.”
§ Clinical course of high-risk patients diagnosed with antiphospholipid syndrome > Data collection and clinical features at diagnosis
boosted- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Recurrence remains frequent despite the use of oral anticoagulants, which significantly reduces the risk of thromboembolism.”
§ Clinical course of high-risk patients diagnosed with antiphospholipid syndrome > Abstract
plain- Asserted: passes — The authors put it forward as true.
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The quote only partly states this claim.
In the paper
“In contrast, multiple positivity shows a marked association with thromboembolic events and severe pregnancy morbidity [8][9][10][11][12][13].”
§ Clinical course of high-risk patients diagnosed with antiphospholipid syndrome > Introduction
What the sources say
- Not matchedcites [8][9][10][11][12][13]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
boostedcorrelational- Asserted: passes — The authors put it forward as true.
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- Not matched
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Oral anticoagulant therapy significantly reduces recurrent thromboembolism, although it might prove insufficient in some cases.”
§ Clinical course of high-risk patients diagnosed with antiphospholipid syndrome > Discussion
hedgeddirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
The paper relies on this without support.
No prior study has described the characteristics and clinical course of APS in high-risk patients positive for all three recommended aPL tests.
“To our knowledge, no study has reported the characteristics and clinical course of a homogenous group of APS patients that are positive in all three laboratory diagnostic tests.”
“The characteristics and the clinical course of antiphospholipid syndrome (APS) in high-risk patients that are positive for all three recommended tests that detect the presence of antiphospholipid (aPL) antibodies have not been described.”
The paper relies on this without support.
This is the first large-scale study to examine the clinical course of a homogeneous cohort of APS patients with full positive laboratory profile.
“To our knowledge, this is the first large-scale study looking at the clinical course of a homogenous cohort of APS patients with full positive laboratory profile.”
“which to our knowledge is the first to examine patients that are positive for APS as determined by three separate tests”
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The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Despite long-term anticoagulation with vitamin K antagonists, patients with thrombotic PAPS remain at substantial risk of recurrent thrombotic events, with cumulative recurrence rates approaching 20% at 5 years in observational cohorts [2].”
From Hydroxychloroquine as an Adjunct Therapy for Secondary Thrombosis Prevention in Primary Antiphospholipid Syndrome: A Systematic Review and Meta-analysis (2026) · cites this paper as [2]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“The incidence was significantly higher in patients not taking OAs (HR 2.4, 95% CI 1.3-4.1,P < 0.003) [11].”
From Antithrombotic effects of hydroxychloroquine in primary antiphospholipid syndrome patients (2013) · cites this paper as [11]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“aPL profiling also involves consideration of antibody titers since higher titers are associated with higher risk [7,8,30,31].”
From Triple-positive antiphospholipid syndrome does not guarantee positivity in each lupus anticoagulant assay (2023) · cites this paper as [7]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Patients positive for the combination of LAC, antiβ 2GPI, and anti-CL antibodies,theso-called triple-positive patients, exhibit a high risk for developing a first thrombotic event and recurrence of thrombosis. 8,9”
From Clinical Relevance of Isolated Lupus Anticoagulant Positivity in Patients with Thrombotic Antiphospholipid Syndrome (2021) · cites this paper as [8]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“andpatientspositiveforallthree aPLs are identified as individuals at high risk for a first clinical event and for recurrence. 8,9”
From Clinical Relevance of Isolated Lupus Anticoagulant Positivity in Patients with Thrombotic Antiphospholipid Syndrome (2021) · cites this paper as [8]
Experimental — accuracy not yet measured
The cited source says what the claim attributes to it.
In the citing paper
“triple positivity (all 3 tests positive) is associated with thrombosis and identifies high-risk patients with aPL syndrome (APS).6,7”
From Incidence of a first thromboembolic event in asymptomatic carriers of high-risk antiphospholipid antibody profile: a multicenter prospective study (2011) · cites this paper as [7]
The cited source says what the claim attributes to it.
In the citing paper
“At 1 year, the cumulative incidence of thromboembolic events was 12.2%, and at 10 years it was 44.2%, in a retrospective study in APS patients [11].”
From Antithrombotic effects of hydroxychloroquine in primary antiphospholipid syndrome patients (2013) · cites this paper as [11]
The cited source says what the claim attributes to it.
In the citing paper
“Of note is that many studies on triple positivity merely report patients as being positive for LA without assessing dRVVT and APTT results separately [10,[23][24][25][26][27][28][29], or even use only 1 assay [7,8,12].”
From Triple-positive antiphospholipid syndrome does not guarantee positivity in each lupus anticoagulant assay (2023) · cites this paper as [7]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
“The qualifying events at diagnosis were venous thromboembolism (76 cases; 47.5%), arterial thromboembolism (69 cases; 43.1%) and pregnancy morbidity (11 cases; 9.7%).”
§ Clinical course of high-risk patients diagnosed with antiphospholipid syndrome > Abstract
Reported 9.7 · recomputed 6.875
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
“| Other | 34 (19.3) |”
§ Clinical course of high-risk patients diagnosed with antiphospholipid syndrome > Discussion
Reported 19.3 · recomputed 21.25
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
“Table 1 Demographic and clinical characteristics at diagnosis of 160 highrisk APS patients* | Characteristics | | | --- | --- | | Age years | 41.1 ± 15.0 | | Female -no. (%) | 113 (70.6) | | APS-related event at diagnosis -no. (%) | | | VTE | 76 (47.5) | | Arterial Thrombosis | 69 (43.1) | | Obstetric complications | 11 (6.9) | | Catastrophic APS | 4 (2.5) | | Autoimmune disorders -no.(%) | | | SLE | 33 (18.8) |”
§ Clinical course of high-risk patients diagnosed with antiphospholipid syndrome > Discussion
Reported 18.8 · recomputed 20.625
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
“| Risk for arterial thrombosis -no. (%) | 87 (49.4) |”
§ Clinical course of high-risk patients diagnosed with antiphospholipid syndrome > Discussion
Reported 49.4 · recomputed 54.375
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
“| Risk for venous thrombosisà -no. (%) | 71 (40.3) |”
§ Clinical course of high-risk patients diagnosed with antiphospholipid syndrome > Discussion
Reported 40.3 · recomputed 44.375
Citations
Cites
MIYAKIS, S., LOCKSHIN, M. D., ATSUMI, T., BRANCH, D. W., BREY, R. L., CERVERA, R., DERKSEN, R. H. W. M., DE GROOT, P. G., KOIKE, T., MERONI, P. L., et al. (2006) · Journal of Thrombosis and Haemostasis · doi:10.1111/j.1538-7836.2006.01753.x · Cited by 7,203
Cervera, R., Piette, J., Font, J., Khamashta, M. A., Shoenfeld, Y., Camps, M. T., Jacobsen, S., Lakos, G., Tincani, A., Kontopoulou‐Griva, I., et al. (2002) · Arthritis & Rheumatism · doi:10.1002/art.10187 · Cited by 2,156
Antithrombotic Therapy for Venous Thromboembolic Disease
Hyers, T. M., Agnelli, G., Hull, R. D., Morris, T. A., Samama, M. M., Tapson, V. F., & Weg, J. G. (2001) · CHEST Journal · doi:10.1378/chest.119.1_suppl.176s · Cited by 2,035
The management of thrombosis in the antiphospholipid-antibody syndrome
Khamashta, M. A., Cuadrado, M. J., Mujic, F., Taub, N. A., Hunt, B. J., & Hughes, G. R. V. (1995) · New England Journal of Medicine · doi:10.1056/nejm199504133321504 · Cited by 1,450
Antithrombotic Therapy for Venous Thromboembolic Disease
Büller, H. R., Agnelli, G., Hull, R. D., Hyers, T. M., Prins, M. H., & Raskob, G. E. (2004) · Chest · doi:10.1378/chest.126.3_suppl.401s · Cited by 1,249
Kearon, C., Gent, M., Hirsh, J., Weitz, J. I., Kovacs, M. J., Anderson, D. R., Turpie, A. G. G., Green, D., Ginsberg, J. S., Wells, P. S., et al. (1999) · New England Journal of Medicine · doi:10.1056/nejm199903253401201 · Cited by 1,057
Cervera, R., Serrano, R., Pons-Estel, G. J., Ceberio-Hualde, L., Shoenfeld, Y., de Ramón, E., Buonaiuto, V, Jacobsen, S., Zeher, M. M., Tarr, T., et al. (2015) · Annals of the Rheumatic Diseases · doi:10.1136/annrheumdis-2013-204838 · Cited by 974
Galli, M., Luciani, D., Bertolini, G., & Barbui, T. (2003) · Blood · doi:10.1182/blood-2002-02-0441 · Cited by 972
Crowther, M. A., Ginsberg, J. S., Julian, J., Denburg, J., Hirsh, J., Douketis, J., Laskin, C., Fortin, P., Anderson, D., Kearon, C., et al. (2003) · New England Journal of Medicine · doi:10.1056/nejmoa035241 · Cited by 919
Asherson, R. A., Cervera, R., de Groot, P. G., Erkan, D., Boffa, M., Pietté, J. C., Khamashta, M. A., Shoenfeld, Y., & Catastrophic Antiphospholipid Syndrome Registry Project Group (2003) · Lupus · doi:10.1191/0961203303lu394oa · Cited by 863
Cited by
Sorted by citations
2019 update of the EULAR recommendations for the management of systemic lupus erythematosus
Fanouriakis, A., Kostopoulou, M., Alunno, A., Aringer, M., Bajema, I., Boletis, J. N., Cervera, R., Doria, A., Gordon, C., Govoni, M., et al. (2019) · Annals of the Rheumatic Diseases · doi:10.1136/annrheumdis-2019-215089 · Cited by 2,011
“138 Patients with SLE with aPL may also receive additional anticoagulant treatment, such as low-molecular weight heparin, during high-risk periods for thrombosis (pregnancy or postoperatively), although no studies have formally addressed this question.”
Ruiz‐Irastorza, G., Crowther, M. A., Branch, W. D., & Khamashta, M. A. (2010) · The Lancet · doi:10.1016/s0140-6736(10)60709-x · Cited by 875
Rivaroxaban vs warfarin in high-risk patients with antiphospholipid syndrome
Pengo, V., Denas, G., Zoppellaro, G., Jose, S. P., Hoxha, A., Ruffatti, A., Andreoli, L., Tincani, A., Cenci, C., Prisco, D., et al. (2018) · Blood · doi:10.1182/blood-2018-04-848333 · Cited by 822
Self-citationDiagnosis and management of the antiphospholipid syndrome
Garcia, D., & Erkan, D. (2018) · New England Journal of Medicine · doi:10.1056/nejmra1705454 · Cited by 819
Guidelines on the investigation and management of antiphospholipid syndrome
Keeling, D., Mackie, I., Moore, G. W., Greer, I. A., Greaves, M., & British Committee for Standards in Haematology (2012) · British Journal of Haematology · doi:10.1111/j.1365-2141.2012.09037.x · Cited by 740
“The ‘GRADE’ system was used to quote levels and grades of evidence, details of which can be found at http://www.bcshguidelines.com/BCSH_PRO-”
BackgroundMethod
Metadata
- Authors
- PENGO, V., RUFFATTI, A., LEGNANI, C., GRESELE, P., BARCELLONA, D., ERBA, N., TESTA, S., MARONGIU, F., BISON, E., DENAS, G., BANZATO, A., PADAYATTIL JOSE, S., & ILICETO, S.
- Affiliations
- University of Padua (IT)
- University of Bologna (IT)
- University of Perugia (IT)
- University of Cagliari (IT)
- Corresponding author
- PENGO, V.
- ORCID
- Venue
- Journal of Thrombosis and Haemostasis
- Publisher
- Elsevier BV
- Published
- 2010-02
- Volume
- 8
- Issue
- 2
- Pages
- 237-242
- ISSN
- 1538-7836 (ISSN-L)
- OpenAlex
- W2119266650
- Cited by
- 632
- References
- 39
- Citations by year
- 2026: 37 · 2025: 31 · 2024: 40 · 2023: 47 · 2022: 52 · 2021: 45 · 2020: 55 · 2019: 50 · 2018: 41 · 2017: 33 · 2016: 38 · 2015: 35 · 2014: 32 · 2013: 30 · 2012: 30
- FWCI
- 12.84
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Thrombosis and Haemostasis (publishedVersion)
- PubMed (publishedVersion)
- UNICA IRIS Institutional Research Information System (University of Cagliari) (submittedVersion)
- 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
- antiphospholipid syndrome, triple positivity, lupus anticoagulant, anticardiolipin antibodies, anti-beta2-glycoprotein I antibodies, venous thromboembolism, arterial thromboembolism, pregnancy morbidity, catastrophic antiphospholipid syndrome, oral anticoagulation, thromboembolic recurrence, major bleeding, cardiovascular mortality
- MeSH terms
- Administration, Oral, Adult, Aged, Anticoagulants, Catastrophic Illness, Female, Hemorrhage, Humans, Italy, Male, Middle Aged, Predictive Value of Tests, Pregnancy, Pregnancy Complications, Cardiovascular, Recurrence, Retrospective Studies, Risk Factors, Time Factors, Biomarkers, Incidence, Proportional Hazards Models, Lupus Coagulation Inhibitor, Antiphospholipid Syndrome, Treatment Outcome, Antibodies, Antiphospholipid, Antibodies, Anticardiolipin, Disease Progression, Risk Assessment, Kaplan-Meier Estimate, beta 2-Glycoprotein I, Venous Thromboembolism
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-10-08, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-10-08 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Cited sources are checked with a language model’s help (gpt-6-sol).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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