The DOI matches its Crossref record; 51 of the 51 references it cites were found in a registry or an index.
Antiphospholipid antibodies and venous thromboembolism
Abstract
The clinical relevance of antiphospholipid antibodies (APLA) in patients without systemic lupus erythematosus who have venous thromboembolism (VTE) in unknown. Limited evidence suggests that there is an association between the presence of APLA and both initial and recurrent episodes of VTE and that patients with APLA and VTE are resistant to warfarin therapy. Unselected patients with a first episode of clinically suspected deep vein thrombosis or pulmonary embolism were evaluated with objective tests for VTE and with laboratory tests for APLA; the latter included tests for the lupus anticoagulant (LA) and anticardiolipin antibodies (ACLA). Patients with VTE were treated with anticoagulant therapy and observed during and after discontinuation of anticoagulants for symptomatic recurrence of VTE. There was a strong association between LA and VTE (odds ratio, 9.4; 95% confidence interval [CI], 2.1 to 46.2) and 9 to 65 (14%; 95% CI, 7% to 25%) patients with VTE had LA. There was no association between the presence of ACLA and VTE (odds ratio, 0.7; 95%CI, 0.3 to 1.7) because of the high frequency of positive ACLA assays in patients without VTE. None of the 16 patients with VTE and APLA developed recurrent VTE while receiving warfarin therapy. There was no difference in rates of recurrent VTE in patients with or without APLA after anticoagulant therapy was discontinued. The strong association between LA and VTE suggests that testing for LA in patients with VTE is useful. The measurement of ACLA in patients with VTE has no clinical usefulness because the results are abnormal in a high proportion of patients without VTE. Although the presence of APLA in patients with VTE was not associated with resistance to a conventional intensity of warfarin or an increased risk of recurrent VTE after discontinuation of warfarin, a larger study should address these issues in a subgroup of patients with VTE and LA.
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“Use of long-term anticoagulation in patients with APS is supported by two small direct comparison studies (one RCT, one retrospective cohort)28 29 that showed a lower risk of recurrent venous thrombosis among patients with APS on long-term vs 3–6 months of oral anticoagulation.”
From EULAR recommendations for the management of antiphospholipid syndrome in adults (2019) · cites this paper as [29]
Citations
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Levine, J. S., Branch, D. W., & Rauch, J. (2002) · New England Journal of Medicine · doi:10.1056/nejmra002974 · Cited by 1,524
EULAR recommendations for the management of antiphospholipid syndrome in adults
Tektonidou, M. G., Andreoli, L., Limper, M., Amoura, Z., Cervera, R., Costedoat-Chalumeau, N., Cuadrado, M. J., Dörner, T., Ferrer-Oliveras, R., Hambly, K., et al. (2019) · Annals of the Rheumatic Diseases · doi:10.1136/annrheumdis-2019-215213 · Cited by 1,318
Tapson, V. F. (2008) · New England Journal of Medicine · doi:10.1056/nejmra072753 · Cited by 1,018
Galli, M., Luciani, D., Bertolini, G., & Barbui, T. (2003) · Blood · doi:10.1182/blood-2002-02-0441 · Cited by 972
Impact of the patient population on the risk for heparin-induced thrombocytopenia
Warkentin, T. E., Sheppard, J. I., Horsewood, P., Simpson, P. J., Moore, J. C., & Kelton, J. G. (2000) · Blood · doi:10.1182/blood.v96.5.1703 · Cited by 923
Metadata
- Authors
- Ginsberg, J., Wells, P., Brill-Edwards, P., Donovan, D., Moffatt, K., Johnston, M., Stevens, P., & Hirsh, J.
- Affiliations
- McMaster University (CA)
- ORCID
- Hirsh, J
- Venue
- Blood
- Publisher
- American Society of Hematology
- Published
- 1995-11-15
- Volume
- 86
- Issue
- 10
- Pages
- 3685-3691
- ISSN
- 0006-4971 (ISSN-L)
- 1528-0020
- OpenAlex
- W2157778986
- Cited by
- 365
- References
- 51
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 3 · 2023: 3 · 2022: 3 · 2021: 7 · 2020: 4 · 2019: 7 · 2018: 2 · 2017: 4 · 2016: 4 · 2015: 4 · 2014: 8 · 2013: 7 · 2012: 7
- FWCI
- 14.59
- 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 › Internal Medicine › Venous Thromboembolism Diagnosis and Management
- Health Sciences › Medicine › Hematology › Blood Coagulation and Thrombosis Mechanisms
- Keywords
- antiphospholipid antibodies, venous thromboembolism, lupus anticoagulant, anticardiolipin antibodies, deep vein thrombosis, pulmonary embolism, recurrent venous thromboembolism, warfarin resistance, anticoagulation, systemic lupus erythematosus
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Anticoagulants, Autoimmune Diseases, Female, Humans, Male, Middle Aged, Ontario, Predictive Value of Tests, Prospective Studies, Pulmonary Embolism, Thrombophlebitis, Warfarin, Lupus Coagulation Inhibitor, Antiphospholipid Syndrome, Antibodies, Antiphospholipid, Antibodies, Anticardiolipin
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