Antiphospholipid antibodies and venous thromboembolism

Ginsberg, JS; Wells, P. S.; Brill-Edwards, P; Donovan, Dianne; Moffatt, Kody; Johnston, Marilyn; Stevens, P; Hirsh, Jack

doi:10.1182/blood.v86.10.3685.bloodjournal86103685

Cited by 341 publications

(165 citation statements)

References 44 publications

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“…The aPL antibodies were detected in three of 113 prepubertal obese children, corresponding to 2.65% and in two of 77 pubertal obese children, corresponding to 2.59%. These percentages are not significantly different from percentages reported by Ginsberg et al (1995), who found aPL antibodies in 2% of healthy adults by using LA test. No statistically significant difference was evaluated among the different considered groups as reported in Table 2.…”

Section: Discussioncontrasting

confidence: 73%

Antiphospholipid antibodies and lipoprotein(a) in obese children

et al. 2009

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The presence of various prothrombotic risk factors increases the probability of developing thrombosis. Considering aPL antibodies there is no statistically significant difference among the different considered groups; therefore each category has the same risk factor. The Lp(a) distribution in adults is significantly different from the Lp(a) distribution in prepubertal (p = 0.012) and pubertal (p = 0.029) obese children. There is no significant difference among prepubertal subjects (p = 0.632) as well as pubertal subjects (p = 0.465), independently from the BMI. These results suggest the control of BMI in young population to avoid the presence of the obesity as another independent prothrombotic risk factor to be added to aPL and Lp(a) in the future adulthood.

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Section: Discussioncontrasting

confidence: 73%

Antiphospholipid antibodies and lipoprotein(a) in obese children

et al. 2009

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“…We have found 4 positive LAC patients in a cohort of 436 controls (0.9%). Ginsberg et al [9] found three positive samples in a total of 179 patients referred for suspected venous thrombosis who turned out not to have venous thrombosis (1.7%), while Simioni et al [10] did not find any positive LAC in their control cohort of 117 persons (0%). In an older study Nencini et al [10] studied 55 healthy volunteers and found only one LAC positive person (1.8%).…”

Section: Discussionmentioning

confidence: 95%

Lupus anticoagulants and the risk of a first episode of deep venous thrombosis

Groot

Lutters

Derksen

et al. 2005

Journal of Thrombosis and Haemostasis

180

104

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To cite this article: de Groot PG, Lutters B, Derksen RHWM, Lisman T, Meijers JCM, Rosendaal FR. Lupus anticoagulants and the risk of a first episode of deep venous thrombosis. J Thromb Haemost 2005; 3: 1993-7.Summary. We have determined lupus anticoagulants, anti-b 2 glycoprotein I (b 2 GPI) and antiprothrombin antibodies in the Leiden Thrombophilia Study, a population-based casecontrol study designed to determine risk factors for deep venous thrombosis (DVT). Lupus anticoagulant (LAC) was measured in 473 patients and 472 control subjects. Four control subjects (0.9%) and 14 patients (3.1%) had a positive LAC, resulting in a 3.6-fold increased risk [odds ratio (OR) 3.6, 95% CI: 1.2-10.9]. Of the total population, 49 were positive for anti-b 2 GPI antibodies: 15 controls (3.4%) and 34 patients (7.5%), implying a 2.4-fold increased risk (95% CI: 1.3-4.2). Antiprothrombin antibodies were present in 114 subjects: 48 controls (11.0%) and 66 cases (14.6%) with an OR of 1.4 (95% CI: 1.0-2.1). When LAC was considered in the co-presence of antiprothrombin or anti-b 2 GPI antibodies the OR increased to 10.1 (95% CI: 1.3-79.8). A LAC without a positive anti-b 2 GPI or antiprothrombin test was not associated with a risk for DVT (OR 1.3,. This study demonstrates that the presence of LAC, anti-b 2 GPI antibodies and antiprothrombin antibodies are risk factors for DVT in a general population. The strongest association holds for the combination LAC and the presence of anti-b 2 GPI or antiprothrombin antibodies.

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“…As with other patients who have thrombophilic disorders, antiphospholipid syndrome patients with recurrent venous thrombosis are frequently placed on long-term oral anticoagulant therapy. However, there is conflicting opinion as to the intensity of therapy these patients should receive (Khamashta et al, 1995;Ginsberg et al, 1995), and prospective, randomized clinical trials are required (Finazzi & Barbui, 1996). Standardization of oral anticoagulant therapy is essential, and the best system for this described so far is the INR system developed by W.H.O.…”

Section: Discussionmentioning

confidence: 99%

“…values should be maintained above 3 . 0, whereas Ginsberg et al (1995), in their prospective study, suggested that an INR of 2 . 0-3 .…”

mentioning

confidence: 93%

Monitoring of oral anticoagulant therapy in lupus anticoagulant positive patients with the anti‐phospholipid syndrome

et al. 1997

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Introduction of the International Normalized Ratio (INR) has improved the standardization of laboratory control of oral anticoagulant therapy (OAT). However, it has been reported that misleading INR results can be obtained from OAT patients with lupus anticoagulant (LA). To investigate this claim, we studied 35 OAT patients, 14 of whom had anti‐phospholipid syndrome (APS) with a documented LA. Attainment of anticoagulation was confirmed by chromogenic assay of factor VII and factor X. Prothrombin times were performed using eight thromboplastins (five derived from rabbit brain, two recombinant human tissue factor and one made from human placenta) with an International Sensitivity Index (ISI) of <1.40. When using the thromboplastin manufacturers' ISI there was a significant difference (ANOVA, P<0.0001) between INR results obtained with the eight reagents for both APS (average CV = 12.4%) and non‐APS (average CV = 12.5%) patient groups. Variation using the eight thromboplastins was assessed by calculating the CV for each sample; these values were then pooled for each patient group to give the average CV for all samples with all reagents for the two patient groups. Results for both patient groups exhibited markedly reduced variation (APS group average CV = 6.5%, non‐APS group average CV = 5.8%) when locally assigned ISI values were employed in the calculation of INRs. Our data does not support the suggestion that the INR may not reflect the true level of anticoagulation in the long‐term warfarin‐treated patient, in whom lupus anticoagulant was detected. However, there was strong evidence that thromboplastin use should be restricted to those clot detection systems for which the reagent's manufacturer has assigned an ISI, or local ISI assignment must be undertaken. The inappropriate use of a generic (i.e. optical or mechanical clot detection system without regard to specific analyser type) ISI value can lead to ambiguous results.

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Antiphospholipid antibodies and venous thromboembolism

Cited by 341 publications

References 44 publications

Antiphospholipid antibodies and lipoprotein(a) in obese children

Antiphospholipid antibodies and lipoprotein(a) in obese children

Lupus anticoagulants and the risk of a first episode of deep venous thrombosis

Monitoring of oral anticoagulant therapy in lupus anticoagulant positive patients with the anti‐phospholipid syndrome

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