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Cited by 93Systemic Lupus Erythematosus ResearchBlood Coagulation and Thrombosis MechanismsVasculitis and related conditions

Thrombotic risk assessment in the antiphospholipid syndrome requires more than the quantification of lupus anticoagulants

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Devreese, Katrien, Peerlinck, Kathelijne, Hoylaerts, Marc F.·2010·Blood
DOI 10.1182/blood-2009-09-244426
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Abstract

Lupus anticoagulants (LACs) are associated with thromboembolic complications (TECs). LACs can be detected by their anticoagulant properties in thrombin generation assays, by the peak height (PH) and lag time (LT). To assess the thrombotic risk in LAC-positive patients, we have expressed the LAC activity quantitatively by PH/LT calibration curves, constructed for mixtures of monoclonal antibodies against β2-glycoprotein I (β2GPI) and prothrombin, spiked in normal plasma. PH/LT was determined in LAC patients, with (n = 38) and without (n = 21) TECs and converted into arbitrary LAC units. LAC titers ranged from 0 to 200 AU/mL, with 5 of 59 patients being negative. In the positive LAC titer population (54 of 59), LAC and anti-β2GPI immunoglobulin G (IgG) titers correlated with TECs, with odds ratios of 3.54 (95% CI, 1.0-1.7) and 10.0 (95% CI, 1.98-50.6), respectively. In patients with single or combined low titers, useful predictions on thrombosis could be made only after additional measurements of soluble P-selectin and factor VII. This layered strategy yielded positive and negative predictive values, sensitivity, and specificity values approximately 90% in this subgroup. Hence, LAC and anti-β2GPI IgG titers, when combined with selected markers of the hypercoagulable state, allow a relevant thrombotic risk assessment in nearly all patients with LACs.

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Cited by

Sorted by citations

Authors
Devreese, K., Peerlinck, K., & Hoylaerts, M. F.
Affiliations
  • Ghent University Hospital (BE)
  • KU Leuven (BE)
ORCID
Venue
Blood
Publisher
American Society of Hematology
Published
2010-01-28
Volume
115
Issue
4
Pages
870-878
ISSN
  • 0006-4971 (ISSN-L)
  • 1528-0020
DOI
10.1182/blood-2009-09-244426
OpenAlex
W1993331725
Cited by
93
References
6
Citations by year
2025: 2 · 2024: 8 · 2023: 6 · 2022: 3 · 2021: 8 · 2020: 6 · 2019: 4 · 2018: 7 · 2017: 11 · 2016: 6 · 2015: 4 · 2014: 6 · 2013: 3 · 2012: 8
FWCI
4.23
Type
journal article
Language
en
Open access
Locations
  • Blood (publishedVersion)
  • PubMed (publishedVersion)
  • Ghent University Academic Bibliography (Ghent University) (submittedVersion)
  • Lirias (submittedVersion)
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 syndrome, lupus anticoagulant, thrombotic risk assessment, thrombin generation assay, beta2-glycoprotein I, thrombosis, soluble P-selectin, factor VII, hypercoagulability, thrombosis prediction
MeSH terms
Adult, Antibodies, Monoclonal, Antibody Specificity, Blood Coagulation, Calibration, Factor VII, Humans, Immunoglobulin G, Predictive Value of Tests, Prothrombin, Risk Factors, Thrombosis, Biomarkers, Seroepidemiologic Studies, Lupus Coagulation Inhibitor, Antiphospholipid Syndrome, Risk Assessment, P-Selectin, beta 2-Glycoprotein I

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