Stéphane Zuily1, Bas de Laat2, Shirine Mohamed3, Hilde Kelchtermans4, Zakera Shums5, Roger Albesa5, Gary L Norman5, Claire Lamboux-Matthieu6, Anne-Christine Rat7, Jacques Ninet8, Nadine Magy-Bertrand9, Jean-Louis Pasquali10, Marc Lambert11, Bernard Lorcerie12, Pierre Kaminsky3, Francis Guillemin13, Véronique Regnault14, Denis Wahl15. 1. CHU de Nancy, Regional Competence Centre for Rare Vascular and Systemic Autoimmune Diseases, Vascular Medicine Division, Inserm, UMRS 1116, Nancy School of Medicine, Université de Lorraine, Nancy, France, s.zuily@chu-nancy.fr. 2. Biochemistry, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, Clinical Chemistry and Haematology, University Medical Centre Utrecht, Synapse BV, Maastricht, Department of Plasma Proteins/Blood coagulation, Sanquin Research, Amsterdam, The Netherlands. 3. Nancy School of Medicine, Université de Lorraine, Nancy, France, CHU de Nancy, Orphan Disease Unit, Nancy, France. 4. Biochemistry, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht. 5. Research and Development, Inova Diagnostics, San Diego, CA, USA. 6. CHU de Nancy, Regional Competence Centre for Rare Vascular and Systemic Autoimmune Diseases, Vascular Medicine Division. 7. Université de Lorraine, Paris Descartes University, APEMAC, EA 4360, Inserm, CIC-EC 1433, CHU de Nancy, Clinical Epidemiology and Evaluation Department, CHU de Nancy, Rheumatology Department, Nancy. 8. CHU de Lyon, Department of Internal Medicine, Lyon. 9. CHRU de Besançon, Internal Medicine Department, Besançon. 10. CHU de Strasbourg, Internal Medicine and Clinical Immunology Department, Strasbourg, F-67000. 11. CHRU de Lille, Department of Internal Medicine, Lille. 12. CHU de Dijon, Internal Medicine and Clinical Immunology Department, Dijon and. 13. Université de Lorraine, Paris Descartes University, APEMAC, EA 4360, Inserm, CIC-EC 1433, CHU de Nancy, Clinical Epidemiology and Evaluation Department. 14. Inserm, UMRS 1116, CHU de Nancy, Contrat d'interface, Nancy, France. 15. CHU de Nancy, Regional Competence Centre for Rare Vascular and Systemic Autoimmune Diseases, Vascular Medicine Division, Inserm, UMRS 1116, Nancy School of Medicine, Université de Lorraine, Nancy, France.
Abstract
OBJECTIVE: To investigate the validity of the global APS score (GAPSS) to predict thrombosis in patients with autoimmune diseases. METHODS: This prospective cohort study included consecutive patients with aPL or SLE. aPL, aPS-PT and GAPSS were determined. A Cox proportional hazards model assessed the validity of GAPSS and identified other potential independent predictors of thrombosis. RESULTS: One hundred and thirty-seven patients [43.5 (s.d. 15.4) years old; 107 women] were followed up for a mean duration of 43.1 (s.d. 20.7) months. Mean GAPSS was significantly higher in patients who experienced a thrombotic event compared with those without [10.88 (s.d. 5.06) vs 8.15 (s.d. 5.31), respectively, P = 0.038]. In univariate analysis, age [hazard ratio (HR) = 1.04 (95% CI 1.01, 1.08)] and GAPSS above 16 [HR = 6.86 (95% CI 1.90, 24.77)] were each significantly associated with thrombosis during follow-up, while history of arterial thrombosis [HR = 2.61 (95% CI 0.87, 7.82)] failed to reach significance. Among aPL assays, IgG aPS/PT--a component of the GAPSS--was significantly associated with thrombosis [HR = 2.95 (95% CI 1.02, 8.51)]. In multivariate analysis, GAPSS above 16 remained the only significant predictor of thrombosis [HR = 6.17 (95% CI 1.70, 22.40)]. CONCLUSION: This first external validation study confirmed that GAPSS can predict thrombosis in patients with aPL and associated autoimmune diseases.
OBJECTIVE: To investigate the validity of the global APS score (GAPSS) to predict thrombosis in patients with autoimmune diseases. METHODS: This prospective cohort study included consecutive patients with aPL or SLE. aPL, aPS-PT and GAPSS were determined. A Cox proportional hazards model assessed the validity of GAPSS and identified other potential independent predictors of thrombosis. RESULTS: One hundred and thirty-seven patients [43.5 (s.d. 15.4) years old; 107 women] were followed up for a mean duration of 43.1 (s.d. 20.7) months. Mean GAPSS was significantly higher in patients who experienced a thrombotic event compared with those without [10.88 (s.d. 5.06) vs 8.15 (s.d. 5.31), respectively, P = 0.038]. In univariate analysis, age [hazard ratio (HR) = 1.04 (95% CI 1.01, 1.08)] and GAPSS above 16 [HR = 6.86 (95% CI 1.90, 24.77)] were each significantly associated with thrombosis during follow-up, while history of arterial thrombosis [HR = 2.61 (95% CI 0.87, 7.82)] failed to reach significance. Among aPL assays, IgG aPS/PT--a component of the GAPSS--was significantly associated with thrombosis [HR = 2.95 (95% CI 1.02, 8.51)]. In multivariate analysis, GAPSS above 16 remained the only significant predictor of thrombosis [HR = 6.17 (95% CI 1.70, 22.40)]. CONCLUSION: This first external validation study confirmed that GAPSS can predict thrombosis in patients with aPL and associated autoimmune diseases.
Authors: Daniel Navarro-Carpentieri; Maria Del Carmen Castillo-Hernandez; Karim Majluf-Cruz; Guillermo Espejo-Godinez; Paola Carmona-Olvera; Manuel Moreno-Hernandez; Yolanda Lugo-García; Jesús Hernandez-Juarez; Luis Loarca-Piña; Irma Isordia-Salas; Abraham Majluf-Cruz Journal: Clin Appl Thromb Hemost Date: 2017-09-08 Impact factor: 2.389
Authors: Stéphane Zuily; Isabelle Clerc-Urmès; Cédric Bauman; Danieli Andrade; Savino Sciascia; Vittorio Pengo; Maria G Tektonidou; Amaia Ugarte; Maria Gerosa; H Michael Belmont; Maria Angeles Aguirre Zamorano; Paul Fortin; Lanlan Ji; Maria Efthymiou; Hannah Cohen; D Ware Branch; Guilherme Ramires de Jesus; Cecilia Nalli; Michelle Petri; Esther Rodriguez; Ricard Cervera; Jason S Knight; Tatsuya Atsumi; Rohan Willis; Maria Laura Bertolaccini; Joann Vega; Denis Wahl; Doruk Erkan Journal: Lupus Date: 2020-07-23 Impact factor: 2.911