抗脂抗体阳性患者死亡率的预测因素:来自临床试验的抗脂综合征联盟和国际网络临床数据库和存储库的前性结果
Yasaman Ahmadzadeh1, Larry S Magder2, Danieli Castro Oliveira de Andrade3
1Roger Williams Medical Center, Providence, Rhode, Island.
Arthritis care & research
|February 3, 2025
概括
在抗脂抗体 (aPL) 阳性患者中,死亡率在五年内为5%. 动脉血栓,自身免疫性疾病和心血管风险因素独立预测死亡,特别是在老年患者中.
科学领域:
- 类风湿病学 类风湿病学
- 免疫学 免疫学 免疫学
- 临床医学 临床医学
背景情况:
- 抗脂抗体 (aPLs) 与血栓形成和妊娠并发症的风险增加有关.
- 抗脂综合征 (APS) 是一种临床疾病,其特点是存在aPLs时出现复发性血栓形成或怀孕发病率.
- 了解aPL阳性患者的死亡率对于风险分层和管理至关重要.
研究的目的:
- 为了确定aPL阳性患者的死亡率.
- 确定这个群体中死亡的原因和预测因素.
- 为了比较患有APS分类和没有APS分类的患者之间的死亡率.
主要方法:
- 来自APS ACTION注册表的967名aPLs.阳性患者的前性分析.
- 每12 ± 3个月进行一次临床数据和血液采集后续检查.
- 使用考克斯比例危险和卡普兰-梅尔模型分析死亡原因和风险因素.
主要成果:
- 在平均5.3年的随访后,在43名患者中观察到5%的死亡率.
- 死亡的患者年龄较大,患动脉血栓,灾难性APS,并发性全身自身免疫性疾病 (SAID) 和基线心血管疾病 (CVD) 风险因素的可能性更高.
- 动脉血栓 (HR 2.94),并发性SAIDs (HR 2.97),和基线心血管疾病风险因素 (HR 2.43) 独立预测死亡率.
结论:
- 持久性aPL阳性患者的死亡率在五年内为5%.
- 死亡率在登记时年龄≥60岁的患者中最高.
- 动脉血栓形成史,并发性SAID和基线心血管疾病风险因素是死亡的独立预测因素.
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