Journal article
Antiphospholipid antibodies and recurrent thrombosis after a first unprovoked venous thromboembolism
Blood, Vol.131(19), pp.2151-2160
05/10/2018
DOI: 10.1182/blood-2017-09-805689
PMCID: PMC6536697
PMID: 29490924
Abstract
It is uncertain whether antiphospholipid antibodies (APAs) increase the risk of recurrence after a first unprovoked venous thromboembolism (VTE). We tested for anticardiolipin antibodies, anti-β2 glycoprotein 1 antibodies, and lupus anticoagulant on 2 occasions ∼6 months apart in 307 patients with a first unprovoked VTE who were part of a prospective cohort study. We then determined if APAs were associated with recurrent thrombosis in the 290 patients who stopped anticoagulant therapy in response to negative D-dimer results. Compared with those without an APA, the hazard ratios for recurrent VTE were 1.8 (95% confidence interval [CI], 0.9-3.7;
= .09) in the 25.9% of patients with an APA on ≥1 occasions, 2.7 (95% CI, 1.1-.7;
= .03) in the 9.0% of patients with the same APA on 2 occasions, and 4.5 (95% CI, 1.5-13.0;
= .006) in the 3.8% of patients with 2 or 3 different APA types on either the same or different occasions. There was no association between having an APA and D-dimer levels. We conclude that having the same type of APA on 2 occasions or having >1 type of APA on the same or different occasions is associated with recurrent thrombosis in patients with a first unprovoked VTE who stop anticoagulant therapy in response to negative D-dimer tests. APA and D-dimer levels seem to be independent predictors of recurrence in patients with an unprovoked VTE. This trial was registered at www.clinicaltrials.gov as #NCT00720915.
Details
- Title: Subtitle
- Antiphospholipid antibodies and recurrent thrombosis after a first unprovoked venous thromboembolism
- Creators
- Clive Kearon - McMaster UniversitySameer Parpia - McMaster UniversityFrederick A Spencer - McMaster UniversityTrevor Baglin - Addenbrooke's HospitalScott M Stevens - Intermountain Medical CenterKenneth A Bauer - Harvard UniversitySteven R Lentz - University of IowaCraig M Kessler - Georgetown UniversityJames D Douketis - McMaster UniversityStephan Moll - University of North Carolina at Chapel HillScott Kaatz - Hurley Medical CenterSam Schulman - McMaster UniversityJean M Connors - Harvard UniversityJeffrey S Ginsberg - McMaster UniversityLuciana Spadafora - McMaster UniversityVinai Bhagirath - McMaster UniversityPatricia C Liaw - McMaster UniversityJeffrey I Weitz - McMaster UniversityJim A Julian - McMaster University
- Resource Type
- Journal article
- Publication Details
- Blood, Vol.131(19), pp.2151-2160
- DOI
- 10.1182/blood-2017-09-805689
- PMID
- 29490924
- PMCID
- PMC6536697
- ISSN
- 0006-4971
- eISSN
- 1528-0020
- Grant note
- MOP-84303 / CIHR
- Language
- English
- Date published
- 05/10/2018
- Academic Unit
- Hematology, Oncology, and Blood & Marrow Transplantation; Internal Medicine
- Record Identifier
- 9984359892002771
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