Sage Journals: Discover world-class research

Abstract

Objective

The objective of this report is to independently validate the adjusted Global Antiphospholipid Syndrome Score (aGAPSS) to predict thrombosis in a cohort of patients with APS and/or autoimmune disease.

Methods

This retrospective cohort study included 319 consecutive patients with APS and/or autoimmune disease. Data on clinical manifestations, conventional cardiovascular risk factors and aPL profile were collected. The aGAPSS was calculated for each patient by adding together the points corresponding to the risk factors.

Results

Among the 319 patients included (mean age: 48.0; SD 15.47), conducted over a mean period of 52 months (range: 19–394), 219 fulfilled the current APS classification criteria (PAPS diagnosed in 130 patients and APS associated autoimmune disease (aAPS) in 89 patients), and 100 patients with autoimmune disease without APS (AD). A total of 201 patients (63.0%) had a history of one or several thrombotic manifestations, 189 (86.3%) of them APS patients: 118 PAPS (mean age: 50.14; SD 15.47) and 71 aAPS (mean age: 48.13; SD 15.81). Higher aGAPSS baseline values were seen in patients with thrombosis 6.58 (SD 3.36) when compared with those without 4.90 (SD 4.33) (p = 0.001).

Conclusions

This study has shown that even when anti-phosphatidylserine/prothrombin antibodies (aPS/PT) are not computed in an adjusted model of GAPSS (aGAPSS), this score represents an improvement in assessment of the risk prediction of thrombosis in APS patients and/or autoimmune disease. However, cut-off values may differ from other kinds of cohorts, which suggests that baseline characteristics in divergent groups of patients can account for differences in cut-off values of GAPSS.

Keywords

Antiphospholipid antibodies autoimmune disease thrombosis lupus anticoagulant

Get full access to this article

View all access options for this article.

References

Miyakis

Lockshin

Atsumi

et al.

International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). J Thromb Haemost 2006; 4: 295–306.

Galli

Luciani

Bertolini

Barbui

. Lupus anticoagulants are stronger risk factors for thrombosis than anticardiolipin antibodies in the antiphospholipid syndrome: A systematic review of the literature. Blood 2003; 101: 1827–1832.

Pengo

Ruffatti

Legnani

et al.

Clinical course of high-risk patients diagnosed with antiphospholipid syndrome. J Thromb Haemost 2010; 8: 237–242.

Hansen

Kong

Moore

Ortel

. Risk factors associated with thrombosis in patients with antiphospholipid antibodies. J Rheumatol 2001; 28: 2018–2024.

Ruffatti

Del Ross

Ciprian

et al.

Risk factors for a first thrombotic event in antiphospholipid antibody carriers. A multicentre, retrospective follow-up study. Ann Rheum Dis 2009; 68: 397–399.

Erkan

Yazici

Peterson

Sammaritano

Lockshin

. A cross-sectional study of clinical thrombotic risk factors and preventive treatments in antiphospholipid syndrome. Rheumatology (Oxford) 2002; 41: 924–929.

Forastiero

Martinuzzo

. The emerging role of multiple antiphospholipid antibodies positivity in patients with antiphospholipid syndrome. Expert Rev Clin Immunol 2015; 11: 1255–1263.

Sciascia

Cosseddu

Montaruli

Kuzenko

Bertero

. Risk scale for the diagnosis of antiphospholipid syndrome. Ann Rheum Dis 2011; 70: 1517–1518.

Otomo

Atsumi

Amengual

et al.

Efficacy of the antiphospholipid score for the diagnosis of antiphospholipid syndrome and its predictive value for thrombotic events. Arthritis Rheum 2012; 64: 504–512.

10.

Sciascia

Sanna

Murru

Roccatello

Khamashta

Bertolaccini

. GAPSS: The Global Anti-Phospholipid Syndrome Score. Rheumatology (Oxford) 2013; 52: 1397–1403.

11.

Oku

Amengual

Bohgaki

Horita

Yasuda

Atsumi

. An independent validation of the Global Anti-Phospholipid Syndrome Score in a Japanese cohort of patients with autoimmune diseases. Lupus 2015; 24: 774–775.

12.

Zuily

de Laat

Mohamed

et al.

Validity of the global anti-phospholipid syndrome score to predict thrombosis: A prospective multicentre cohort study. Rheumatology (Oxford) 2015; 54: 2071–2075.

13.

Sciascia

Sanna

Murru

Roccatello

Khamashta

Bertolaccini

. The global anti-phospholipid syndrome score in primary APS. Rheumatology (Oxford) 2015; 54: 134–138.

14.

Pengo

Tripodi

Reber

et al.

Update of the guidelines for lupus anticoagulant detection. Subcommittee on Lupus Anticoagulant/Antiphospholipid Antibody of the Scientific and Standardisation Committee of the International Society on Thrombosis and Haemostasis. J Thromb Haemost 2009; 7: 1737–1740.

15.

Pengo

. ISTH guidelines on lupus anticoagulant testing. Thromb Res 2012; 130(Suppl 1): S76–S77.

16.

D’Agostino

Sr Vasan

Pencina

et al.

General cardiovascular risk profile for use in primary care: The Framingham Heart Study. Circulation 2008; 117: 743–753.

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

0.29 MB

Independent validation of the adjusted GAPSS: Role of thrombotic risk assessment in the real-life setting

Abstract

Objective

Methods

Results

Conclusions

Keywords

Get full access to this article

References

Supplementary Material