Antiphospholipid antibodies and thrombosis: association with acquired activated protein C resistance in venous thrombosis and with hyperhomocysteinemia in arterial thrombosis

Autor: Jeannine Kassis, Rebecca Subang, Lawrence Joseph, Joyce Rauch, Erika R. Chang, Paul R. Fortin, Martine Le Comte, Carolyn Neville, Lambert Busque
Rok vydání: 2004
Předmět:
Male
030204 cardiovascular system & hematology
Cohort Studies
0302 clinical medicine
Risk Factors
immune system diseases
Odds Ratio
Thrombophilia
Venous Thrombosis
0303 health sciences
Lupus anticoagulant
biology
Factor V
Hematology
Middle Aged
Antiphospholipid Syndrome
Thrombosis
3. Good health
Venous thrombosis
Phenotype
beta 2-Glycoprotein I
Lupus Coagulation Inhibitor
Antibodies
Antiphospholipid
Regression Analysis
Female
Adult
medicine.medical_specialty
Hyperhomocysteinemia
Article
03 medical and health sciences
Antiphospholipid syndrome
Internal medicine
medicine
Factor V Leiden
Humans
Carotid Artery Thrombosis
neoplasms
Activated Protein C Resistance
Glycoproteins
030304 developmental biology
business.industry
medicine.disease
Blood Cell Count
Surgery
Logistic Models
Antibodies
Anticardiolipin
Mutation
biology.protein
Activated protein C resistance
business
Zdroj: Thrombosis and Haemostasis. 92:1312-1319
ISSN: 2567-689X
0340-6245
DOI: 10.1160/th04-03-0138
Popis: SummaryAlthough antiphospholipid antibodies (aPL) are associated with thrombosis, it is not known who with aPL is at higher risk for thrombosis. It was the aim of this cross-sectional study to investigate how thrombophilic factors contribute to venous or arterial thrombosis in aPL-positive individuals. In outpatient test centres at two tertiary care hospitals, two hundred and eight (208) persons requiring aPL testing were matched by age, gender and centre to 208 persons requiring a complete blood count. Persons were classified as aPL-positive (having anticardiolipin, lupus anticoagulant and/or anti-β2-glycoprotein I antibodies) or aPL-negative. Several thrombophilic factors were studied using logistic regression modelling. Results showed that the aPL-positive group had three-fold more events (37%) than the aPL-negative group (12%). In unadjusted analyses, clinically important associations were observed between factor V Leiden and venous thrombosis, hyperhomocysteinemia and arterial thrombosis, and activated protein C resistance (APCR) and venous thrombosis (OR, 95% CI = 4.00, 1.35-11.91; 4.79, 2.03-11.33; and 2.03, 1.03-3.97, respectively). After adjusting for recruitment group, persons with both APCR and aPL had a three-fold greater risk (OR, 95% CI = 3.31, 1.30-8.41) for venous thrombosis than those with neither APCR nor aPL. Similarly, after adjusting for hypertension, family history of cardiovascular disease, gender and recruitment group, persons with both hyperhomocysteinemia and aPL had a five-fold increased risk (OR, 95% CI = 4.90, 1.37-17.37) for arterial thrombosis compared to those with neither risk factor. In conclusion, APCR phenotype and hyperhomocysteinemia are associated with a higher risk of venous and arterial thrombosis, respectively, in the presence of aPL.
Databáze: OpenAIRE
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