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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“Antiphospholipid antibodies are found in the healthy general population, but they are frequently found in individuals with SLE.”
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“The LA test correlates better with clinical events than aCL and anti-β2GPI tests do.(3) Moderate to high titers of aCL (≥40 GPL or MPL) or aβ2GPI (≥99th percentile) correlate better with aPL-related clinical events than lower titers do; IgG is more strongly associated with clinical events than IgM is.”
MethodOlah, Z., Szarvas, M., Bereczky, Z., Kerenyi, A., Kappelmayer, J., & Boda, Z. (2013) · Archives of Pathology and Laboratory Medicine · doi:10.5858/arpa.2012-0236-oa · Cited by 11
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de Meis, E., Monteiro, R. Q., & Levy, R. A. (2009) · Autoimmunity Reviews · doi:10.1016/j.autrev.2009.01.010 · Cited by 11
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“Anticardiolipin and anti2-GPI antibody testing must be interpreted with knowledge that many commercial and locally developed assays suffer from both a lack of standardization and significant batch-to-batch variability (9, 10).”
BackgroundSistema del complemento como pieza clave en la patogenia del síndrome antifosfolipídico obstétrico
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“It is therefore not surprising that antibodies against these two abundant proteins (which are involved in maintaining hemostasis) are most consistently associated with LA activity, the most significant predictor of thrombosis risk in APS patients [57].”
BackgroundAntiphospholipid syndrome in pregnancy
Soh, M. C., & Nelson‐Piercy, C. (2010) · Expert Review of Obstetrics & Gynecology · doi:10.1586/eog.10.57 · Cited by 11
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Antiphospholipid antibodies and thrombosis
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“13 16 Tetra-positivity including the three criteria tests plus aPS/PT was recently reported to impose even higher risk for APS-related events compared to the conventional triple positivity (anti-b 2 GPI, anti-CL and LA).”
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“In a systematic review of patients with APLS, lupus anticoagulants were deemed to be stronger risk factors of thrombosis than anticardiolipin antibodies [17].”
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Antiphospholipid antibodies in chronic thromboembolic pulmonary hypertension
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“Lupus anticoagulant (LAC) has been consistently associated with a first episode of VTE and ATE, whereas studies report a variable thrombotic risk with anticardiolipin (aCL) according to the study design and antibody titer cutoffs used.(13,14) Anti-b2 glycoprotein 1 (ab2GP1) antibodies are likely associated with a mode…”
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Antiphospholipid Antibodies and Risk for Recurrent Vascular Events
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“58 While this study faced criticism, other research also failed to establish a correlation between elevated aCL levels and thrombosis.”
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“Positive lupus anticoagulant is associated with a higher risk of thrombosis [26].”
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“Epidemiologic studies regarding the role of aPL for thrombosis and pregnancy morbidity have been systematically reviewed in the past [128–131].”
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The Activated Seven Lupus Anticoagulant Assay Detects Clinically Significant Antibodies
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“The study concentrated on the presence of LA, which better correlated with thrombosis in APS (and SLE) than ACAs.16 Thirteen of these patients additionally had SLE.”
BackgroundInfluentialThe antiphospholipid antibody syndrome
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Clinical and Prognostic Significance of Lupus Anticoagulant Measurement in Patients With Lung Cancer
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“As we know, patients with lung cancer usually exhibit more serious disorders of coagulation function, and higher risk for DVT than other malignancies patients, which would more easily result in metastasis of tumor cells, and recurrence of lung cancer.(13) Therefore, patients with lung cancer would have higher morbidit…”
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“Der dRVVT-Test (ein Enzym der RussellViper, das den Faktor X direkt in Gegenwart von Phospholipiden aktiviert) wird als der beste Screening- und Bestätigungstest für das LA bei erhöhtem Thromboserisiko empfohlen [12].”
BackgroundLaboratory tests in rheumatology: A rational approach
Suresh, E. (2019) · Cleveland Clinic Journal of Medicine · doi:10.3949/ccjm.86a.18076 · Cited by 9
Antiphospholipid antibodies: do we still need to perform anticardiolipin ELISA assays?
de Moerloose, P., & Reber, G. (2004) · Journal of Thrombosis and Haemostasis · doi:10.1111/j.1538-7836.2004.00811.x · Cited by 9
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Lupus, antiphospholipid syndrome, and stroke: An attempt to crossmatch
Hasbani, G. E., & Uthman, I. W. (2023) · Lupus · doi:10.1177/09612033231165151 · Cited by 10
“4.(31) Interestingly, acute ischemic stroke has been reported in LAC positive COVID-19 patients.”
BackgroundStanisavljević, N., Stojanovich, L., Djoković, A., Todic, B., Dopsaj, V., Saponjski, J., Šaponjski, D., Marković, O., Belizna, C. C., Zdravkovic, M. D., et al. (2022) · International Journal of Molecular Sciences · doi:10.3390/ijms232012309 · Cited by 8
Acute Coronary Syndromes in Antiphospholipid Syndrome-above Suspicion: A Systematic Review
Nevras, V., Milaras, N., Katsioulis, C., Sotiriou, Z., Tsalamandris, S., Gkounti, G., & Sideris, S. K. (2022) · Current Problems in Cardiology · doi:10.1016/j.cpcardiol.2022.101503 · Cited by 8
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“Patients with lung cancer typically manifest more severe coagulation abnormalities and a higher incidence of venous thromboembolism (VTE) than patients with other malignancies.(31,32) Multiple coagulation factors and signaling pathways are involved in the mechanisms underlying the increased incidence of hypercoagulabi…”
BackgroundAntiphospholipid syndrome in the era of COVID-19 – Two sides of a coin
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Contracepção e gravidez após transplante hepático: uma visão atual
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How to use… lupus anticoagulants
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Antiphospholipid Syndrome in Patients with Venous Thromboembolism
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“23 Indeed, IgG antibodies that recognize epitope Gly40-Arg43indomainIof β 2GPIshowedLAactivityandwere stronglyassociatedwiththrombosis.”
BackgroundMastorodemos, V. C., Mamoulaki, M., Kritikos, H. D., Plaitakis, A., & Boumpas, D. T. (2006) · PubMed · Cited by 8
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“Further, to improve screening sensitivity, it is necessary to add lupus anticoagulant to anti-b2GPI (18).”
BackgroundCerebral venous sinus thrombosis after gender reassignment surgery
Oster, J. M., Shastri, P., & Geyer, C. A. (2010) · Gender Medicine · doi:10.1016/j.genm.2010.06.005 · Cited by 8
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“Depending on the number and type of assays positive for LA or the titer of LA the risk of developing thrombosis varies [3-5].”
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“A systematic review of 25 studies conducted prior to the revised APS classification criteria suggested that LA is a strong risk factor for both arterial and venous thrombosis.(24) A prospective follow-up observation of 258 aPL carriers showed that the Table 2.”
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“98 Hispanic ethnicity 16 (16) 16 (27) 0 <0.”
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“Furthermore, a systematic review of published articles on APS has shown that LA is a clear risk factor for thrombosis, irrespective of the site and type of thrombosis, the presence of SLE and the methods used to detect them [ 23 ].”
MethodSíndrome antifosfolípido: estado actual
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“Both aCL and ab2 GPI were found to not be so closely related with thromboembolism (8, 9).”
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“…that was discovered in 1990 to be a cofactor for anti-cardiolipin antibodies from patients with APS (McNeil et al., 1989; Galli et al., 1990; Matsuura et al., 1992). β2GPI appears to correlate strongly with a significantly increased risk of thrombosis (Galli et al., 2003; de Laat et al., 2004).”
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Laboratory Evaluation of Antiphospholipid Syndrome
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Treatment of Antiphospholipid Syndrome
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Thrombophilien bei Patienten mit ischämischem Schlaganfall
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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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