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Persistent antiphospholipid antibodies are associated with thrombotic events in ANCA-associated vasculitis: A
Juyoung Yoo1, Sung Soo Ahn1, Seung Min Jung1
1Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
Aim:
We investigated whether persistent antiphospholipid syndrome (APLAs) at diagnosis are associated with the risk of thrombotic events during follow-up in patients with ANCA-associated vasculitis (AAV).
Methods:
We retrospectively reviewed the medical records of 138 AAV patients. Thrombotic events were defined as arterial and venous thrombosis confirmed by magnetic resonance imaging, computed tomography, angiography and Doppler ultrasonography. Clinical and laboratory variables at diagnosis and during follow-up between patients with and without thrombotic events were compared. The univariable and multivariable Cox hazard model analyse to appropriately obtain hazard ratio (HR) considering the follow-up duration were conducted.
Results:
The mean age of 138 AAV patients was 55.1 years and 44 were male. Persistent APLAs were detected in 18 patients with AAV (13.0%). Thrombotic events were observed in 26 patients with AAV (18.8%) during follow-up. At the time of a retrospective study point, persistent APLAs at diagnosis were observed more frequently in patients with thrombotic events than those without. In the multivariable Cox hazard model analysis, age at diagnosis (HR 1.075) and persistent APLAs (HR 2.902), but not ANCAs. Thrombotic events were identified more frequently in patients with persistent APLAs at diagnosis than those without (38.9% vs. 15.8%, relative risk 3.383).
Conclusion:
Persistent APLAs at diagnosis are significantly associated with the risk of thrombotic events during follow-up of AAV. We suggest that physicians should closely monitor the development of thrombotic events during follow-up.
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