Patterns of Recurrent Thrombosis in Primary Antiphospholipid Syndrome-Multicenter, Real-Life Long-Term Follow-Up

Area of Science:

• Cardiology
• Hematology
• Immunology

Background:

• Antiphospholipid syndrome (APS) is an acquired hypercoagulable state linked to antiphospholipid antibodies (aPL).
• Limited data exist on thrombosis recurrence rates after an initial diagnosis of APS.

Purpose of the Study:

• To analyze the incidence and patterns of new thrombotic events in primary APS (pAPS) patients.
• To identify risk factors associated with different recurrence patterns in pAPS.

Main Methods:

• Retrospective analysis of 312 primary APS patients from three Israeli medical centers.
• Follow-up period of up to 15 years to identify new thrombotic events.
• Classification of thrombotic events into arterial, venous, combined, and breakthrough patterns.

Main Results:

• 46% of pAPS patients experienced new thrombotic events.
• Arterial recurrence linked to heart valve disease, hypertension, and elevated anti-B2-GPI IgM.
• Venous recurrence associated with prior venous thrombosis, heart valve disease, and younger age.
• A 'Breakthrough pattern' of recurrence despite prophylaxis occurred in 70% of those with new events, linked to heart valve disease and prior venous thrombosis.

Conclusions:

• Re-thrombosis is a frequent complication in pAPS, occurring even under prophylactic treatment.
• Distinct patterns of thrombotic recurrence are associated with specific clinical, serological, and comorbidity factors.
• Further research is needed to develop effective interventions to prevent recurrent thrombotic events in APS patients.