Antiphospholipid Antibodies and Recurrent Thrombotic Events: Persistence and Portfolio
Open accessAbstract
Background: There are very limited prospective data on the significance of persistent antiphospholipid antibodies (aPL) and recurrent thrombo-occlusive events (TOEs). We investigated the prognostic value of (1) 2 newer aPL assays, (2) an aPL portfolio and (3) persistent aPL positivity following stroke. Methods: A total of 1,770 subjects from the APASS-WARSS study underwent further aPL testing for antibodies to phosphatidylserine (aPS) and anti-β 2-glycoprotein-I (anti-β 2 GPI) from stored sera. Follow-up aPL status was also tested in a subset of subjects. Primary analysis was based on time to any TOE (ischemic stroke, myocardial infarction, transient ischemic attack, deep vein thrombosis, pulmonary embolism or systemic arterial occlusion)/death at 2 years. Cox proportional hazard analyses assessed whether aPL independently related to outcome. Results: Persistent anti-β 2 GPI decreased the time to TOE/death after adjustment for potential confounders (hazards ratio (HR) 2.86, 95% CI 1.21-6.76, p = 0.017). When persistent anti-β 2 GPI was combined with another persistently positive aPL, time to TOE/death was also reduced (HR 3.79, 95% CI 1.18-12.14, p = 0.025). Neither persistent anticardiolipin antibodies nor persistent aPS alone nor a single positive anti-β 2 GPI nor aPS was associated with decreased time to TOE/death. No single positive aPL, portfolio of baseline aPL or any persistent aPL increased the rate of TOE/death. Conclusions: Rates of TOE/death were not influenced by aPL results at baseline or follow-up. Persistent anti-β 2 GPI alone, and with persistent second aPL, was independently associated with decreased time to TOE/death. Persistent aPL, an aPL portfolio and newer aPL in ischemic stroke patients are not helpful in predicting an increased rate of recurrent TOEs.
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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 [33]
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- Authors
- Amory, C. F., Levine, S. R., Brey, R. L., Gebregziabher, M., Tuhrim, S., Tilley, B. C., Simpson, A.-C. C., Sacco, R. L., Mohr, J. P., & Collaborators, F. T. A.-W.
- Affiliations
- Albany Medical Center Hospital (US)
- State University of New York (US)
- The University of Texas at San Antonio Health Science Center (US)
- Medical University of South Carolina (US)
- Icahn School of Medicine at Mount Sinai (US)
- University of Miami (US)
- Columbia University Irving Medical Center (US)
- ORCID
- Venue
- Cerebrovascular Diseases
- Publisher
- S. Karger AG
- Published
- 2015
- Volume
- 40
- Issue
- 5-6
- Pages
- 293-300
- ISSN
- 1015-9770 (ISSN-L)
- 1421-9786
- PMC
- PMC4659726
- OpenAlex
- W2252739686
- Cited by
- 31
- References
- 50
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 3 · 2023: 3 · 2022: 2 · 2021: 3 · 2020: 5 · 2019: 4 · 2018: 3 · 2017: 5 · 2016: 1
- FWCI
- 2.52
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Cerebrovascular Diseases (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Heart, Lung, and Blood Institute (R01HL096944)
- National Institute of Neurological Disorders and Stroke (R01NS052417, R01-NS-30896, R01NS52417, R01-NS-28371, K24NS043992, K24NS43992, T32NS051147, R01NS030896, R01NS028371)
- Topics
- Health Sciences › Medicine › Rheumatology › Systemic Lupus Erythematosus Research
- Health Sciences › Medicine › Hematology › Blood Coagulation and Thrombosis Mechanisms
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Vasculitis and related conditions
- Keywords
- antiphospholipid antibodies, anti-beta2-glycoprotein I antibodies, antiphosphatidylserine antibodies, anticardiolipin antibodies, ischemic stroke, thromboembolism, prognosis, deep vein thrombosis, pulmonary embolism, myocardial infarction, transient ischemic attack
- MeSH terms
- Aged, Autoantigens, Brain Ischemia, Double-Blind Method, Female, Follow-Up Studies, Humans, Male, Middle Aged, Myocardial Infarction, Phosphatidylserines, Pulmonary Embolism, Recurrence, Risk Factors, Thrombosis, Confounding Factors, Epidemiologic, Antiphospholipid Syndrome, Antibodies, Antiphospholipid, Thrombophilia, Kaplan-Meier Estimate, beta 2-Glycoprotein I
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.
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.
What counts as a claim ›How we measure confidence ›How we check this ›
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