Gabriela Medina1, Erik Antonio Cimé Aké2, Olga Vera-Lastra2, Miguel Ángel Saavedra3, María Del Pilar Cruz-Domínguez4, Mary-Carmen Amigo5, Luis J Jara6. 1. Translational Research Unit, Hospital de Especialidades Centro Médico La Raza, IMSS, Universidad Nacional Autónoma de México, Mexico City, Mexico. 2. Internal Medicine Department, Hospital de Especialidades Centro Médico La Raza, IMSS, Universidad Nacional Autónoma de México, Mexico City, Mexico. 3. Rheumatology Department, Hospital de Especialidades Centro Médico La Raza, IMSS, Universidad Nacional Autónoma de México, Mexico City, Mexico. 4. Research Division, Hospital de Especialidades Centro Médico La Raza, IMSS, Universidad Nacional Autónoma de México, Mexico City, Mexico. 5. Centro Médico ABC, Mexico City, Mexico. 6. Direction of Education and Research, Hospital de Especialidades Centro Médico La Raza, IMSS, Universidad Nacional Autónoma de México, Mexico City, Mexico.
Abstract
BACKGROUND: Consequences of organ damage in primary antiphospholipid syndrome (PAPS) are diverse, our aim was to determine organ damage over time and the correlation of organ damage accrual with health-related quality of life (HRQoL) in PAPS. METHODS: First phase: retrospective cohort applying Damage Index for Antiphospholipid Syndrome (DIAPS) at 1, 5, 10, 20 years, or longer since diagnosis. Second phase: cross-sectional study, assessing HRQoL by the Medical Outcomes Study Short Form 36 (SF-36), and organ damage accrual. Descriptive statistics and Spearman correlation coefficient were used. RESULTS: Sixty-seven patients were included, mean follow-up:15 years. Deep vein thrombosis prevailed (71.6%), pulmonary embolism (35.8%) and stroke (32.8%). Organ damage was found in 98.5%, with a cumulative DIAPS value of 3, with greater involvement in the neuropsychiatric and peripheral vascular domains. Regarding HRQoL, deterioration in the physical component summary (PCS) was found in 89.6%. Organ damage accrual correlated inversely and significantly with all the SF-36 domains, mainly with the total score and PCS. Body pain and PCS correlated the most (rho = -0.503, rho = -0.475). CONCLUSIONS: Organ damage accrual impaired HRQoL in PAPS. Secondary thromboprophylxis through adequate systemic management and control of cardiovascular risk factors are necessary to prevent further impairment.
BACKGROUND: Consequences of organ damage in primary antiphospholipid syndrome (PAPS) are diverse, our aim was to determine organ damage over time and the correlation of organ damage accrual with health-related quality of life (HRQoL) in PAPS. METHODS: First phase: retrospective cohort applying Damage Index for Antiphospholipid Syndrome (DIAPS) at 1, 5, 10, 20 years, or longer since diagnosis. Second phase: cross-sectional study, assessing HRQoL by the Medical Outcomes Study Short Form 36 (SF-36), and organ damage accrual. Descriptive statistics and Spearman correlation coefficient were used. RESULTS: Sixty-seven patients were included, mean follow-up:15 years. Deep vein thrombosis prevailed (71.6%), pulmonary embolism (35.8%) and stroke (32.8%). Organ damage was found in 98.5%, with a cumulative DIAPS value of 3, with greater involvement in the neuropsychiatric and peripheral vascular domains. Regarding HRQoL, deterioration in the physical component summary (PCS) was found in 89.6%. Organ damage accrual correlated inversely and significantly with all the SF-36 domains, mainly with the total score and PCS. Body pain and PCS correlated the most (rho = -0.503, rho = -0.475). CONCLUSIONS: Organ damage accrual impaired HRQoL in PAPS. Secondary thromboprophylxis through adequate systemic management and control of cardiovascular risk factors are necessary to prevent further impairment.
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Keywords:
Damage Index for Antiphospholipid Syndrome; Primary antiphospholipid syndrome; health related quality of life; neuropsychiatric damage; organ damage accrual