PO.2.37 Risk factors for recurrent thrombosis and cause of death in patients with antiphospholipid syndrome; a Swedish cohort study

BackgroundIn patients with the antiphospholipid syndrome (APS), recurrent thrombosis (re-thrombosis) is common despite anticoagulation and the mortality rate is high. Concomitant systemic autoimmune rheumatic diseases (SARD) are frequent in patients with APS and often associated with disease associa...

Full description

Saved in:
Bibliographic Details
Published in:Lupus science & medicine 2022-10, Vol.9 (Suppl 2), p.A42-A43
Main Authors: Karandyszowska, N, Alagündüz, H, Oesman, J, Magnusson, M, Svenungsson, E, Bruzelius, M, Antovic, A
Format: Article
Language:English
Subjects:
Autoimmune diseases
Bacterial infections
Cohort analysis
Kidney diseases
Mortality
Risk factors
Sepsis
Thrombosis
Thursday 06 October 2022 from 13:00 to 14:10
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:BackgroundIn patients with the antiphospholipid syndrome (APS), recurrent thrombosis (re-thrombosis) is common despite anticoagulation and the mortality rate is high. Concomitant systemic autoimmune rheumatic diseases (SARD) are frequent in patients with APS and often associated with disease associated damage. Less is known about the prevalence of non-rheumatic autoimmune diseases (NRAID) in these patients.PurposeTo estimate the incidence of re-thrombosis and death, evaluate the impact of cardiovascular (CV) risk factors and antiphospholipid antibody (aPL) profiles on re-thrombosis and identify causes of death in a novel APS cohort. To evaluate the incidence and prevalence of concomitant autoimmune diseases (AID) in this cohort.MethodsThis retrospective cohort study comprises all patients identified with APS in the electronic medical records at Karolinska University Hospital, Sweden 2014–2020. Descriptive statistics was presented as median and interquartile range (IQR). Cox proportional hazards regression analyses were used to investigate the effect of risk factors.Results271 patients were included in the cohort. Age of APS-diagnosis was 43 years (IQR 31–55) and 66% were women. At inclusion, 130 (48%) patients presented with AID; 101 (37%) had a concomitant SARD while 54 (19%) had a NRAID. Systemic lupus erythematosus was the most frequent in 30%, followed by autoimmune thyroid disease in 10% of patients. During follow-up, 37 re-thrombosis occurred; 23 arterial and 14 venous events, with an incidence of 3.4 per 100 person-years (95% CI: 2.4–4.7). Significant CV risk factors for re-thrombosis were current smoking; hazard ratio 2.50, p=0.03 and chronic kidney disease; 3.44, p
ISSN:2053-8790
DOI:10.1136/lupus-2022-elm2022.67