ABSTRACT
OBJECTIVE: This study aimed to assess prospectively the role of anti-ß2-glycoprotein I domain I antibody (aß2GPI-DI) and the Global Antiphospholipid Syndrome Score (GAPSS) in identifying antiphospholipid syndrome (APS) patients at higher risk of a new event. METHODS: Thrombotic APS patients were followed from May 2013 to July 2017. At baseline, we measured lupus anticoagulant, IgG/IgM anticardiolipin, anti-ß2-glycoprotein I, antiphosphatidylserine-prothrombin (aPS/PT) and IgG aß2GPI-DI, and calculated GAPSS for each patient. RESULTS: A total of 44 patients (age 43 ± 10 years, 89% female, 73% primary APS) were followed for 39 months (range 9-46 months). Four new thromboses occurred, two of them after vitamin K antagonist interruption. Recurrent patients presented higher GAPSS (median 20) and were triple and aß2GPI-DI positive; non-recurrent patients had lower GAPSS (median 10.5, range 0-20) and lower ratio of triple (33%) and aß2GPI-DI positivities (38%). aß2GPI-DI was associated with higher GAPSS (median 19 vs. 7, p < 0.001; Pearson correlation 0.82, p < 0.001) and had a greater proportion of triple (83% vs. 4%, p < 0.001) and aPS/PT positivity (94% vs. 50%, p = 0.002). CONCLUSION: Our data show a significant correlation between a validated risk score such as GAPSS and the novel antiphospholipid antibody aß2GPI-DI. Future studies are needed. However, one could speculate a role of aß2GPI-DI as a risk-stratifying tool for thrombotic events in APS.
Subject(s)
Antibodies, Antiphospholipid/immunology , Antiphospholipid Syndrome/complications , Risk Assessment/methods , Thrombosis/immunology , beta 2-Glycoprotein I/immunology , Adult , Female , Humans , Logistic Models , Male , Middle Aged , Multivariate Analysis , Phosphatidylserines/immunology , Prospective Studies , Prothrombin/immunology , Risk Factors , Thrombosis/etiologyABSTRACT
Systemic lupus erythematosus (SLE) is a chronic inflammatory autoimmune disease affecting mainly young women. In last decades premature atherosclerosis has been identified as an important cause of mortality due to SLE related risk factors (inflammation and treatment) and metabolic syndrome (MS). MS is a group of risk factors, originating from an abnormal metabolism, with an increased risk for developing atherosclerotic cardiovascular disease. The prevalence of MS varies from 5,5-55,4% in the general population and has been observed up to 40% in SLE, associated with advanced age, low socioeconomic status, lack of exercise, use of high doses of prednisone and disease activity. Treatment should include identification and modification of these risk factors.
