Lupus anticoagulants are stronger risk factors for thrombosis than anticardiolipin antibodies in the antiphospholipid syndrome: a systematic review of the literature
Abstract
To formally establish the risk of lupus anticoagulants and anticardiolipin antibodies for arterial and venous thrombosis, we ran a MEDLINE search of the literature from 1988 to 2000. Studies were selected for their case-control (11), prospective (9), cross-sectional (3), and ambispective (2) design. They provided or enabled us to calculate the odds ratio with 95% confidence interval (CI) of lupus anticoagulants and/or anticardiolipin antibodies for thrombosis in 4184 patients and 3151 controls. Studies were grouped according to the antibody investigated. Five studies compared lupus anticoagulants with anticardiolipin antibodies: the odds ratio with 95% CI of lupus anticoagulants for thrombosis was always significant. None of them found anticardiolipin antibodies were associated with thrombosis. Four studies analyzed only lupus anticoagulants: the odds ratio with 95% CI was always significant. The risk of lupus anticoagulants was independent of the site and type of thrombosis, the presence of systemic lupus erythematosus, and the coagulation tests employed to detect them. Sixteen studies served to assess 28 associations between anticardiolipin antibodies and thrombosis: the odds ratio with 95% CI was significant in 15 cases. Anticardiolipin titer correlated with the odds ratio of thrombosis. In conclusion, the detection of lupus anticoagulants and, possibly, of immunoglobulin G (IgG) anticardiolipin antibodies at medium or high titers helps to identify patients at risk for thrombosis. However, to take full advantage of the conclusions provided by the available evidence, there is an urgent need to harmonize investigational methods.
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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 [29]
Lupus anticoagulant positivity is associated with thromboembolic events.
“It is now clear that LA positivity is associated with TEs.22”
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 [22]
LA positivity is more strongly associated with both arterial and venous thrombosis than either aCL or anti-β2-glycoprotein I antibodies.
“It is well known that LA positivity is more strongly associated with both arterial and venous thrombosis than either aCL or anti-β2-glycoprotein I antibodies [8, 9].”
From Antiphospholipid patterns predict risk of thrombosis in systemic lupus erythematosus (2021) · cites this paper as [9]
Large studies found that IgM aCL and IgM anti-β2-glycoprotein I are not associated with thrombotic events.
“Large studies found that IgM aCL and IgM anti-β2-glycoprotein I are not associated with thrombotic events [9–13].”
From Antiphospholipid patterns predict risk of thrombosis in systemic lupus erythematosus (2021) · cites this paper as [9]
In a systematic review, aCL IgM was not predictive for thrombosis.
“Similarly, in a systematic review, aCL IgM was not predictive for thrombosis [9].”
From Antiphospholipid patterns predict risk of thrombosis in systemic lupus erythematosus (2021) · cites this paper as [9]
In most studies, in SLE, LA is the main predictor of thrombosis.
“In most studies, it has been shown that in SLE, LA is the main predictor of thrombosis [9, 27–29].”
From Antiphospholipid patterns predict risk of thrombosis in systemic lupus erythematosus (2021) · cites this paper as [9]
LA positivity has the strongest association with future thrombotic events among aPL.
“Patients with persistent aPL with or without APS are at increased risk of future thrombotic events, LA positivity having the strongest association with these events.3”
From Lupus anticoagulant test persistence over time and its associations with future thrombotic events (2022) · cites this paper as [3]
Patients with persistent aPL with or without APS are at increased risk of future thrombotic events.
“Patients with persistent aPL with or without APS are at increased risk of future thrombotic events, LA positivity having the strongest association with these events.3”
From Lupus anticoagulant test persistence over time and its associations with future thrombotic events (2022) · cites this paper as [3]
Additional antibodies, most notably aCL and aβ2GPI, were later identified and associated with thrombosis and recurrent spontaneous abortions.
“Additional antibodies, most notably anticardiolipin antibodies (aCL) and anti–glycoprotein-I antibodies (aβ2GPI), were later identified and associated with thrombosis and recurrent spontaneous abortions.2-4”
From Lupus anticoagulant test persistence over time and its associations with future thrombotic events (2022) · cites this paper as [3]
Most prior efforts to risk-stratify patients for future thrombotic events have used aPL status from the first measurement or early in observation and have not analyzed changes over time.
“Notably, most prior efforts to risk-stratify patients for future thrombotic events have used the patients’ aPL status from the first measurement or early in the observation period and have not analyzed changes over time.3,7,8”
From Lupus anticoagulant test persistence over time and its associations with future thrombotic events (2022) · cites this paper as [3]
Meta-analyses indicate that aCL and ab2GPI alone are weakly associated with thromboembolic events.
“This contention is supported by meta-analyses showing that the presence of aCL and ab2GPI alone are poorly associated with thromboembolic events [6,7].”
From Clinical course of high‐risk patients diagnosed with antiphospholipid syndrome (2010) · cites this paper as [6]
A positive LAC is a strong risk factor for thrombosis in APS.
“Although a positive LAC is considered to be a strong risk factor for thrombosis in APS, 10,11”
From Clinical Relevance of Isolated Lupus Anticoagulant Positivity in Patients with Thrombotic Antiphospholipid Syndrome (2021) · cites this paper as [10]
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Laboratory criteria for antiphospholipid syndrome: communication from the SSC of the ISTH
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Antiphospholipid syndrome: advances in diagnosis, pathogenesis, and management
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“60 Antiphospholipid profile A persistently positive lupus anticoagulant test is the single most powerful predictor of thrombotic risk, 16 64 as well as pregnancy morbidity.”
BackgroundInitial presentation of childhood-onset systemic lupus erythematosus: A French multicenter study
Bader‐Meunier, B., Armengaud, J.-B., Haddad, É., et al. (2005) · The Journal of Pediatrics · doi:10.1016/j.jpeds.2004.12.045 · Cited by 258 · see citing works
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“This approach has been previously reported and validated (8, 9).”
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Current concepts on the pathogenesis of the antiphospholipid syndrome
Giannakopoulos, B., Passam, F. H., Rahgozar, S., & Krilis, S. A. (2006) · Blood · doi:10.1182/blood-2006-04-001206 · Cited by 217 · see citing works
Rand, J. H., Wu, X.-X., Quinn, A. S., Chen, P. P., Hathcock, J. J., & Taatjes, D. J. (2008) · Blood · doi:10.1182/blood-2008-03-144204 · Cited by 215 · see citing works
Alijotas‐Reig, J., Esteve‐Valverde, E., Ferrer‐Oliveras, R., Comet, L. S., Lefkou, E. E., MEKINIAN, A., Belizna, C. C., Ruffatti, A., Tincani, A., Marozio, L., et al. (2019) · Autoimmunity Reviews · doi:10.1016/j.autrev.2018.12.006 · Cited by 215 · see citing works
Diagnosing antiphospholipid syndrome: 'extra-criteria' manifestations and technical advances
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The clinical significance of antiphospholipid antibodies in systemic lupus erythematosus
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Lupus anticoagulants and the risk of a first episode of deep venous thrombosis
DE GROOT, P. G., LUTTERS, B., DERKSEN, R. H. W. M., LISMAN, T., MEIJERS, J. C. M., & ROSENDAAL, F. R. (2005) · Journal of Thrombosis and Haemostasis · doi:10.1111/j.1538-7836.2005.01485.x · Cited by 205 · see citing works
The antiphospholipid syndrome in patients with systemic lupus erythematosus
Pons‐Estel, G., Andréoli, L., Scanzi, F., Cervera, R., & Tincani, A. (2016) · Journal of Autoimmunity · doi:10.1016/j.jaut.2016.10.004 · Cited by 203 · see citing works
“Positive LA has been demonstrated to be the aPL test most strongly related to thrombosis [33,34], while isolated ab2-GPI areweakly associatedwith vascularmanifestations [15,33].”
BackgroundHow we diagnose the antiphospholipid syndrome
Giannakopoulos, B., Passam, F. H., Ioannou, Y., & Krilis, S. A. (2008) · Blood · doi:10.1182/blood-2007-12-129627 · Cited by 186 · see citing works
The geoepidemiology of the antiphospholipid antibody syndrome
Biggioggero, M., & Meroni, P. L. (2009) · Autoimmunity Reviews · doi:10.1016/j.autrev.2009.11.013 · Cited by 185 · see citing works
“N40 GPL units) resulted significantly associated with arterial thrombosis (first cerebral stroke or MI) [9].”
BackgroundPierangeli, S., de Groot, P. G., Dlott, J. S., Favaloro, E. J., Harris, E., Lakos, G., Ortel, T. L., Meroni, P. L., Otomo, K., Pengo, V., et al. (2011) · Lupus · doi:10.1177/0961203310395055 · Cited by 179 · see citing works
Does thrombophilia testing help in the clinical management of patients?
Middeldorp, S., & Vlieg, A. V. H. (2008) · British Journal of Haematology · doi:10.1111/j.1365-2141.2008.07339.x · Cited by 175 · see citing works
“The presence of antibodies to anticardiolipin, b2-Glycoprotein I, and prothrombin have been associated with thrombosis in some, but not all, studies (Galli et al, 2003; Galli & Barbui, 2005).”
BackgroundDirect Oral Anticoagulants vs Vitamin K Antagonists in Patients With Antiphospholipid Syndromes
Khairani, C. D., Bejjani, A., Piazza, G., Jiménez, D., Monréal, M., Chatterjee, S., Pengo, V., Woller, S. C., Cortés-Hernández, J., Connors, J. M., et al. (2022) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2022.10.008 · Cited by 178 · see citing works
A prospective study of antibodies to β2‐glycoprotein I and prothrombin, and risk of thrombosis
FORASTIERO, R., MARTINUZZO, M., POMBO, G., PUENTE, D., ROSSI, A., CELEBRIN, L., BONACCORSO, S., & AVERSA, L. (2005) · Journal of Thrombosis and Haemostasis · doi:10.1111/j.1538-7836.2005.01295.x · Cited by 170 · see citing works
Galli, M., Borrelli, G., Jacobsen, E. M., Marfisi, R. M., Finazzi, G., Marchioli, R., Wisloff, F., Marziali, S., Morboeuf, O., & Barbui, T. (2007) · Blood · doi:10.1182/blood-2007-01-066043 · Cited by 170 · see citing works
“In 2003, two systematic reviews of the literature on LA, aCL, aβ2GPI and aPT antibodies showed that LA are the strongest risk factors for both arterial and venous thrombosis, whereas such a role did not clearly emerge for the other antibodies, unless in some selected clinical scenarios (10, 11).”
BackgroundResultSelf-citationPlatelet-Endothelial Interactions: Sepsis, HIT, and Antiphospholipid Syndrome
Warkentin, T. E., Aird, W. C., & Rand, J. H. (2003) · Hematology · doi:10.1182/asheducation-2003.1.497 · Cited by 161 · see citing works
Sciascia, S., Sanna, G., Khamashta, M. A., Cuadrado, M. J., Erkan, D., Andréoli, L., & Bertolaccini, M. L. (2014) · Annals of the Rheumatic Diseases · doi:10.1136/annrheumdis-2014-205663 · Cited by 162 · see citing works
The potential role of heparin in assisted conception
Nelson, S. M., & Greer, I. A. (2008) · Human Reproduction Update · doi:10.1093/humupd/dmn031 · Cited by 160 · see citing works
“†Data derived from non-pregnant related risk of VTE (Galli et al., 2003b).”
BackgroundResultInfluentialZuily, S., Cohen, H., Isenberg, D. A., Woller, S. C., Crowther, M. A., Dufrost, V., Wahl, D. G., Doré, C. J., Cuker, A. C., Carrier, M., et al. (2020) · Journal of Thrombosis and Haemostasis · doi:10.1111/jth.14935 · Cited by 156 · see citing works
Alijotas‐Reig, J., Ferrer‐Oliveras, R., Ruffatti, A., Tincani, A., Lefkou, E. E., Bertero, M. T., Coloma, E., Carolis, S. D., Espinosa, G., Rovere, P. Q., et al. (2014) · Autoimmunity Reviews · doi:10.1016/j.autrev.2014.12.010 · Cited by 152 · see citing works
“[37], in an attempt to reduce the possible over-diagnosis of the syndrome, argued in favour of maintaining antiβ2GPI and also suggested that aCL should be dropped from the diagnostic laboratory panel owing to the lack of association with clinical APS-related disorders.”
The significance of autoantibodies against β2-glycoprotein I
de Groot, P. G., & Urbanus, R. T. (2012) · Blood · doi:10.1182/blood-2012-03-378646 · Cited by 146 · see citing works
Drews, R. E. (2003) · Clinics in Chest Medicine · doi:10.1016/s0272-5231(03)00100-x · Cited by 136 · see citing works
“Paradoxically, lupus anticoagulants and the antiphospholipid antibody syndrome are associated with a tendency to thrombosis not bleeding; the prolonged aPTT is an artifact of the test [27] [28].”
BackgroundGarcia, D. A., Akl, E. A., Carr, R., & Kearon, C. (2013) · Blood · doi:10.1182/blood-2013-04-496257 · Cited by 133 · see citing works
“There is evidence that an LA is more strongly associated with thrombosis than a positive ACLA test.(23) Our analysis was consistent with a stronger association between an LA and recurrent VTE than for ACLA (Figures 3 and 4).”
ResultTincani, A., Allegri, F., Balestrieri, G., Reber, G., Sanmarco, M., Meroni, P. L., & Boffa, M. (2004) · Thrombosis Research · doi:10.1016/j.thromres.2004.06.035 · Cited by 128 · see citing works
Diagnosis of antiphospholipid syndrome in routine clinical practice
Gardiner, C., Hills, J., Machin, S., & Cohen, H. (2013) · Lupus · doi:10.1177/0961203312460722 · Cited by 131 · see citing works
Pathophysiology of the antiphospholipid syndrome
de Groot, P. G., & Derksen, R. H. W. M. (2005) · Journal of Thrombosis and Haemostasis · doi:10.1111/j.1538-7836.2005.01359.x · Cited by 134 · see citing works
Kelchtermans, H., Pelkmans, L., de Laat, B., & Devreese, K. M. J. (2016) · Journal of Thrombosis and Haemostasis · doi:10.1111/jth.13379 · Cited by 131 · see citing works
Mustonen, P., Lehtonen, K. V., Javela, K., & Puurunen, M. (2014) · Lupus · doi:10.1177/0961203314545410 · Cited by 127 · see citing works
Diagnosis and management of the antiphospholipid syndrome
Cohen, D. B., Berger, S. P., Steup‐Beekman, G. M., Bloemenkamp, K. W. M., & Bajema, I. M. (2010) · BMJ · doi:10.1136/bmj.c2541 · Cited by 124 · see citing works
“Antibodies with lupus anticoagulant activity are important clinically—two systematic reviews found them to be strongly correlated with thrombotic and obstetric complications of the syndrome.”
Backgroundde Laat, B., Wu, X.-X., van Lummel, M., Derksen, R. H. W. M., de Groot, P. G., & Rand, J. H. (2007) · Blood · doi:10.1182/blood-2006-07-030148 · Cited by 122 · see citing works
Pathogenesis and management of antiphospholipid syndrome
Arachchillage, D. J., & Laffan, M. (2017) · British Journal of Haematology · doi:10.1111/bjh.14632 · Cited by 120 · see citing works
“Although several clinical studies and systematic reviews suggested that LA is a stronger risk factor for the development of thrombosis (Galli et al, 2003; de Groot et al, 2005), other studies have shown that the presence of LA alone is not associated with thromboembolic events (Pengo et al, 2005;…”
BackgroundLaboratory Tests in the Diagnosis and Follow-Up of Pediatric Rheumatic Diseases: An Update
Breda, L., Nozzi, M., Sanctis, S. D., & Chiarelli, F. (2009) · Seminars in Arthritis and Rheumatism · doi:10.1016/j.semarthrit.2008.12.001 · Cited by 117 · see citing works
The antiphospholipid syndrome: from pathophysiology to treatment
Negrini, S. M., Pappalardo, F., Murdaca, G., Indiveri, F., & Puppo, F. (2016) · Clinical and Experimental Medicine · doi:10.1007/s10238-016-0430-5 · Cited by 117 · see citing works
“LA is strongly associated with venous thrombosis and stroke, particularly in young patients, and with fetal losses beyond the 10th week of gestation [23, 101–104].”
BackgroundAssessment of Hemostatic Risk Factors in Predicting Arterial Thrombotic Events
Feinbloom, D. B., & Bauer, K. A. (2005) · Arteriosclerosis Thrombosis and Vascular Biology · doi:10.1161/01.atv.0000181762.31694.da · Cited by 112 · see citing works
Antiphospholipid syndrome: laboratory detection, mechanisms of action and treatment
Tripodi, A., de Groot, P. G., & Pengo, V. (2011) · Journal of Internal Medicine · doi:10.1111/j.1365-2796.2011.02362.x · Cited by 113 · see citing works
Antiphospholipid Syndrome during pregnancy: the state of the art.
Prima, F. A. F. D., Valenti, O., Hyseni, E., Giorgio, E., Faraci, M., Renda, E., Domenico, R. D., & Monte, S. (2011) · PubMed Central · Cited by 111 · see citing works
Sciascia, S., Bertolaccini, M. L., Roccatello, D., Khamashta, M. A., & Sanna, G. (2014) · Journal of Neurology · doi:10.1007/s00415-014-7406-8 · Cited by 114 · see citing works
“This approach has been previously reported and validated [10, 11].”
MethodLupus Anticoagulant-Hypoprothrombinemia Syndrome
Mazodier, K., Arnaud, L., Mathian, A., Costedoat-Chalumeau, N., Haroche, J., Francès, C., Harlé, J., Pernod, G., Lespessailles, É., Gaudin, P., et al. (2012) · Medicine · doi:10.1097/md.0b013e31826b971f · Cited by 112 · see citing works
Antiphospholipid antibodies in COVID-19: a meta-analysis and systematic review
Taha, M., & Samavati, L. (2021) · RMD Open · doi:10.1136/rmdopen-2021-001580 · Cited by 109 · see citing works
Arnout, J., & Vermylen, J. (2003) · Journal of Thrombosis and Haemostasis · doi:10.1046/j.1538-7836.2003.00125.x · Cited by 107 · see citing works
Gris, J., Bouvier, S., Molinari, N., Galanaud, J. ‐., Cochery-Nouvellon, É., Mercier, É., Fabbro-Péray, P., Balducchi, J.-P., Marès, P., Quéré, I., et al. (2011) · Blood · doi:10.1182/blood-2011-09-381913 · Cited by 108 · see citing works
“Age, y 30 (5) [17-44] 29 (4) [18-44] 29 (4) [16-41] .”
Male, C., Foulon, D., Hoogendoorn, H., Vegh, P., Silverman, E., David, M., & Mitchell, L. (2005) · Blood · doi:10.1182/blood-2005-05-2048 · Cited by 106 · see citing works
“The first was a meta-analysis including 18 studies in adult patients with SLE demonstrating that LA shows stronger association with TEs than ACLAs.1 A more recent systematic review included 25 studies in adult patients with or without SLE.10 The review confirmed LAs as a strong risk factor for TEs but did not find une…”
BackgroundInfluentialA protocol for determination of anticardiolipin antibodies by ELISA
Pierangeli, S. S., & Harris, E. N. (2008) · Nature Protocols · doi:10.1038/nprot.2008.48 · Cited by 106 · see citing works
“The main reason of such statement is based on the results of a large meta-analysis study showing that LA is a strong risk factor for thrombosis at variance of the aCL assa”
ResultLim, W. (2013) · Hematology · doi:10.1182/asheducation-2013.1.675 · Cited by 104 · see citing works
Landolfi, R., Cipriani, M. C., & Novarese, L. (2006) · Best Practice & Research Clinical Haematology · doi:10.1016/j.beha.2005.07.011 · Cited by 99 · see citing works
Antiphospholipid antibody testing and standardization
Devreese, K. M. J. (2014) · International Journal of Laboratory Hematology · doi:10.1111/ijlh.12234 · Cited by 98 · see citing works
“[63, 64], while for pregnancy morbidity the role of IgM should be further established [57, 58].”
BackgroundCerebral Manifestations in the Antiphospholipid (Hughes) Syndrome
Sanna, G., D’Cruz, D. P., & Cuadrado, M. J. (2006) · Rheumatic Disease Clinics of North America · doi:10.1016/j.rdc.2006.05.010 · Cited by 95 · see citing works
Diagnosis and management of non-criteria obstetric antiphospholipid syndrome
Machin, S. J., Mackie, I. J., Cohen, H., & Arachchillage, D. J. (2014) · Thrombosis and Haemostasis · doi:10.1160/th14-05-0416 · Cited by 97 · see citing works
“A meta-analysis of the association between aPL and recurrent fetal loss in women without autoimmune disease, reported that LA, which appears to have the strongest association with thrombosis (23), was associated with late recurrent pregnancy loss (odds ratio [OR] 7.”
BackgroundSurvey of lupus anticoagulant diagnosis by central evaluation of positive plasma samples
Pengo, V., Biasiolo, A., Gresele, P., Marongiu, F., Erba, N., Veschi, F., Ghirarduzzi, A., Candia, E. D., Montaruli, B., Testa, S., et al. (2007) · Journal of Thrombosis and Haemostasis · doi:10.1111/j.1538-7836.2007.02454.x · Cited by 95 · see citing works
Devreese, K., Peerlinck, K., & Hoylaerts, M. F. (2010) · Blood · doi:10.1182/blood-2009-09-244426 · Cited by 93 · see citing works
Mechanisms of Disease: antiphospholipid antibodies—from clinical association to pathologic mechanism
de Laat, B., Mertens, K., & de Groot, P. G. (2008) · Nature Clinical Practice Rheumatology · doi:10.1038/ncprheum0740 · Cited by 90 · see citing works
“The consequence of the low specificity of the assays is the suboptimal treatment of patients”
BackgroundCatastrophic antiphospholipid syndrome: how to diagnose a rare but highly fatal disease
Aguiar, C. L., & Erkan, D. (2013) · Therapeutic Advances in Musculoskeletal Disease · doi:10.1177/1759720x13502919 · Cited by 91 · see citing works
“…diagnostic purposes [Miyakis et al. 2006]; (b) a positive LA test is a better predictor of aPLrelated thrombotic events compared with other aPL tests [Galli et al. 2003]; (c) whenever possible, LA test should be tested off anticoagulation as both false-negative and false-positive results can occur…”
ResultIncidence of a first thromboembolic event in carriers of isolated lupus anticoagulant
Pengo, V., Testa, S., Martinelli, I., Ghirarduzzi, A., Legnani, C., Gresele, P., Passamonti, S. M., Bison, E., Denas, G., Jose, S. P., et al. (2015) · Thrombosis Research · doi:10.1016/j.thromres.2014.10.013 · Cited by 89 · see citing works
Detection of lupus anticoagulant in the presence of rivaroxaban using Taipan snake venom time
OS, G. M. A. V., de Laat, B., Kamphuisen, P. W., Meijers, J. C. M., & de Groot, P. G. (2011) · Journal of Thrombosis and Haemostasis · doi:10.1111/j.1538-7836.2011.04395.x · Cited by 87 · see citing works
Chayoua, W., Kelchtermans, H., Gris, J., Moore, G. W., Musiał, J., Wahl, D., de Groot, P. G., de Laat, B., & Devreese, K. M. J. (2020) · Journal of Thrombosis and Haemostasis · doi:10.1111/jth.14633 · Cited by 89 · see citing works
Secondary immune thrombocytopenic purpura
Liebman, H. A., & Stasi, R. (2007) · Current Opinion in Hematology · doi:10.1097/moh.0b013e3282ab9904 · Cited by 85 · see citing works
How I treat the antiphospholipid syndrome
Giannakopoulos, B., & Krilis, S. A. (2009) · Blood · doi:10.1182/blood-2009-05-220756 · Cited by 83 · see citing works
Laboratory Investigation of Thrombophilia: The Good, the Bad, and the Ugly
Favaloro, E. J., McDonald, D., & Lippi, G. (2009) · Seminars in Thrombosis and Hemostasis · doi:10.1055/s-0029-1242723 · Cited by 84 · see citing works
The Aetiology of Deep Venous Thrombosis
Malone, P. C., & Agutter, P. S. (2007) · Springer eBooks · doi:10.1007/978-1-4020-6650-4 · Cited by 88 · see citing works
When Direct Oral Anticoagulants Should Not Be Standard Treatment
Bejjani, A., Khairani, C. D., Assi, A. A., Piazza, G., Sadeghipour, P., Talasaz, A. H., Fanikos, J. R., Connors, J. M., Siegal, D. M., Barnes, G. D., et al. (2024) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2023.10.038 · Cited by 86 · see citing works
The aetiology of deep venous thrombosis
Malone, P. C. (2006) · QJM · doi:10.1093/qjmed/hcl070 · Cited by 83 · see citing works
Invitation to a debate on the serological criteria that define the antiphospholipid syndrome
GALLI, M., REBER, G., DE MOERLOOSE, P., & DE GROOT, P. G. (2008) · Journal of Thrombosis and Haemostasis · doi:10.1111/j.1538-7836.2008.02862.x · Cited by 85 · see citing works
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Pediatric Antiphospholipid Syndrome
Cimaz, R., & Descloux, É. (2006) · Rheumatic Disease Clinics of North America · doi:10.1016/j.rdc.2006.05.005 · Cited by 81 · see citing works
Svenungsson, E., Gustafsson, J., Leonard, D., Sandling, J. K., Gunnarsson, I., Nordmark, G., Jönsen, A., Bengtsson, A. A., Sturfelt, G. K., Rantapää‐Dahlqvist, S., et al. (2009) · Annals of the Rheumatic Diseases · doi:10.1136/ard.2009.115535 · Cited by 82 · see citing works
Challenges in the Diagnosis of the Antiphospholipid Syndrome
Devreese, K. M. J., & Hoylaerts, M. (2010) · Clinical Chemistry · doi:10.1373/clinchem.2009.133678 · Cited by 82 · see citing works
Venous Thrombosis in the Antiphospholipid Syndrome
Farmer-Boatwright, M. K., & Roubey, R. A. S. (2009) · Arteriosclerosis Thrombosis and Vascular Biology · doi:10.1161/atvbaha.108.182204 · Cited by 79 · see citing works
Laboratory Testing for Lupus Anticoagulants: A Review of Issues Affecting Results
Tripodi, A. (2007) · Clinical Chemistry · doi:10.1373/clinchem.2007.089524 · Cited by 81 · see citing works
Thrombophilia screening revisited: an issue of personalized medicine
Colucci, G., & Tsakiris, D. Α. (2020) · Journal of Thrombosis and Thrombolysis · doi:10.1007/s11239-020-02090-y · Cited by 85 · see citing works
Management of antiphospholipid syndrome
Tuthill, J. I., & Khamashta, M. A. (2009) · Journal of Autoimmunity · doi:10.1016/j.jaut.2009.05.002 · Cited by 78 · see citing works
Laboratory diagnosis of the antiphospholipid syndrome: a plethora of obstacles to overcome
Devreese, K., & Hoylaerts, M. F. (2009) · European Journal Of Haematology · doi:10.1111/j.1600-0609.2009.01243.x · Cited by 78 · see citing works
“Since LAC show the strongest correlation with thrombosis and pregnancy morbidity, LAC-detection seems to be the assay of choice to detect functional aPL antibodies (25, 26, 89).”
BackgroundInfluentialPhenotyping the haemostatic system by thrombography—potential for the estimation of thrombotic risk
Regnault, V., Hemker, H. C., Wahl, D. G., et al. (2004) · Thrombosis Research · doi:10.1016/j.thromres.2004.06.017 · Cited by 78 · see citing works
- Authors
- Galli, M., Luciani, D., Bertolini, G., & Barbui, T.
- Affiliations
- From the Division of Hematology, Ospedali Riuniti, Bergamo, Italy; and Laboratory of Clinical Epidemiology, Mario Negri Institute, Ranica (Bergamo), Italy.
- Venue
- Blood
- Publisher
- American Society of Hematology
- Published
- 2003-03-01
- Volume
- 101
- Issue
- 5
- Pages
- 1827-1832
- ISSN
- 0006-4971 (ISSN-L)
- 1528-0020
- OpenAlex
- W2044043417
- Cited by
- 974
- References
- 66
- Citations by year
- 2026: 17 · 2025: 19 · 2024: 32 · 2023: 26 · 2022: 34 · 2021: 40 · 2020: 37 · 2019: 38 · 2018: 31 · 2017: 40 · 2016: 58 · 2015: 37 · 2014: 39 · 2013: 41 · 2012: 50
- FWCI
- 7.37
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Blood (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Rheumatology › Systemic Lupus Erythematosus Research
- Health Sciences › Medicine › Hematology › Blood Coagulation and Thrombosis Mechanisms
- Health Sciences › Medicine › Surgery › Heparin-Induced Thrombocytopenia and Thrombosis
- Keywords
- lupus anticoagulant, anticardiolipin antibodies, antiphospholipid syndrome, thrombosis, arterial thrombosis, venous thrombosis, thrombosis risk factors, systemic lupus erythematosus
- MeSH terms
- Arterial Occlusive Diseases, Autoantigens, Autoimmune Diseases, Cross-Sectional Studies, Glycoproteins
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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