The DOI matches its Crossref record; 64 of the 66 references it cites were found in a registry or an index.
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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In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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 the citing paper
“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 the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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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BackgroundLaboratory Evaluation of Hypercoagulability
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“Comment IgG aCL isotype testing seems to have the greatest clinical relevance.(42) The use of antibodies conjugated to alkaline phosphatase in NCCLS guidelines appears overly restrictive.”
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Antiphospholipid Antibody Syndrome
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“Hexagonal-phase phospholipids have been shown to be more specific for LA.”
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“thrombosis [8], as well as the lowest intermethod and interlaboratory variation [6, 7, 12] (Figure 1).”
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“In contrast, lupus anticoagulants (LAs) (and to a lesser extent, aCL) are generally thought to correlate with clinical APS manifestations.(31,32) Determining whether (and the degree to which) anti-B2GPI positivity is independently associated with clinical outcomes is important because isolated antiB2GPI positivity is…”
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Metadata
- 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
- 972
- References
- 66
- Citations by year
- 2026: 23 · 2025: 22 · 2024: 32 · 2023: 28 · 2022: 34 · 2021: 40 · 2020: 37 · 2019: 39 · 2018: 30 · 2017: 41 · 2016: 57 · 2015: 36 · 2014: 40 · 2013: 41 · 2012: 50
- FWCI
- 8.77
- 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 › Hematology › Heparin-Induced Thrombocytopenia and Thrombosis
- Keywords
- lupus anticoagulant, anticardiolipin antibodies, antiphospholipid syndrome, thrombosis, arterial thrombosis, venous thrombosis, thrombosis risk factors, systemic lupus erythematosus, antibody titers
- MeSH terms
- Arterial Occlusive Diseases, Autoantigens, Autoimmune Diseases, Cross-Sectional Studies, Glycoproteins, Humans, Myocardial Infarction, Prospective Studies, Prothrombin, Research Design, Risk Factors, Thrombosis, Confidence Intervals, Odds Ratio, Case-Control Studies, Lupus Coagulation Inhibitor, Antiphospholipid Syndrome, Antibodies, Anticardiolipin, Thrombophilia, Venous Thrombosis, Stroke, beta 2-Glycoprotein I
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