Clinical study and follow-up of 100 patients withthe antiphospholipid syndrome

Muñoz-Rodríguez, Francisco José; Font, Josep; Cervera, R; Reverter, Joan Carles; Tàssies, Dolors; Espinosa, Gerard; López‐Soto, Alfonso; Carmona, Francisco; Balasch, Joan; Ordinas, A; Ingelmo, M

doi:10.1016/s0049-0172(99)80029-8

Cited by 109 publications

(82 citation statements)

References 32 publications

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“…The context of other cardiovascular risk factors seems relevant in view of reports of retinal arterial occlusions being associated with cerebrovascular or cardiovascular disease, while retinal venous occlusions have been reported to be the presenting sign of systemic hypertension, diabetes mellitus, and associated with a greater risk of cardiovascular morbidity [21,22,23]. A previous ophthalmic occlusive disease had occurred in 37 patients (10.1%).…”

Section: Resultsmentioning

confidence: 99%

“…In the USA, 35,000 new cases of APA-associated venous thrombosis and 5,000 new cases of arterial thrombosis are diagnosed each year [1]. Under treatment with aspirin, the risk of a recurrent vascular event in APA syndrome has been reported to be 42% as opposed to 19% with oral anticoagulation or 91% after withdrawal of treatment [23]. Thus, the ophthalmologist may play a key role in early recognition of this disease and initiate anticoagulation treatment in order to prevent further episodes of vascular occlusion.…”

Section: Discussionmentioning

confidence: 99%

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Antiphospholipid Antibodies in Ocular Arterial and Venous Occlusive Disease

et al. 2006

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Purpose: It was the aim of this study to evaluate antiphospholipid antibodies (APA), i.e. lupus anticoagulants (LA) and anticardiolipin (ACA) IgG and IgM, in ophthalmic occlusive disease. Methods: Over a 3.5-year period, APA were evaluated in 368 patients. Results: Eighty-six patients (23.4%), compared to 5% in the general population, tested positive for APA. APA did not differ significantly between patients with venous (20.6%) or arterial (25.5%) occlusive disease. This included 93 patients with central retinal vein occlusion (18% APA positive), 67 with retinal branch vein occlusion (24% APA positive), 41 with central retinal artery occlusion (22% APA positive), 53 with retinal branch artery occlusion (32% APA positive), 71 with anterior ischemic optic neuropathy (23% APA positive), 12 with posterior ischemic optic neuropathy (33% APA positive) and 31 patients with amaurosis fugax (23% APA positive). Excluding patients with accepted main risk factors, APA were positive in 15.3% of 85 patients. Conclusion: The high APA prevalence confirms its relevance in ocular occlusive disorders.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Antiphospholipid Antibodies in Ocular Arterial and Venous Occlusive Disease

et al. 2006

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“…This leads to the conclusion that anticoagulant treatment might not sufficiently prevent thrombosis in LA-positive individuals. [28][29][30] Treatment strategies for primary and secondary thromboprophylaxis in aPLA-positive patients and patients with APS are still a matter of debate. [30][31][32] According to our data, thromboprophylaxis in LA-positive individuals should be carefully evaluated to prevent thrombosis and increased mortality.…”

Section: Discussionmentioning

confidence: 99%

Increased mortality in patients with the lupus anticoagulant: the Vienna Lupus Anticoagulant and Thrombosis Study (LATS)

Gebhart¹,

Posch²,

Koder³

et al. 2015

Blood

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• New onset of thrombosis is an independent risk factor for increased mortality in LA-positive individuals.• Life expectancy in our cohort of patients with LA was worse in comparison with an Austrian reference population. Concomitant autoimmune diseases, anticoagulant treatment at baseline, or positivity for anticardiolipin-or anti-b2-glycoprotein I antibodies were not associated with mortality. In a relative survival analysis, our cohort of LA positives showed a persistently worse survival in comparison with an age-, sex-, and study-inclusion-year-matched Austrian reference population. The cumulative relative survival was 95.0% (95% CI, 88.5-98.8) after 5 years and 87.7% (95% CI, 76.3-95.6) after 10 years. We conclude that occurrence of a thrombotic event is associated with higher mortality in patients with LA. Consequently, the prevention of thromboembolic events in LA positives might improve survival. (Blood. 2015;125(22):3477-3483)

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“…They also observed that the rate of recurrence of thrombosis was highest (1.30 per patient-year) during the first 6 months after the cessation of warfarin therapy. In the series by Munoz-Rodriguez et al [9], 91% of the recurrent episodes were in patients in whom anticoagulant and antiaggregant therapy were discontinued.…”

Section: Secondary Prevention Of Venous Thrombosismentioning

confidence: 96%

“…In addition, patients with aCLs had a high risk of recurrence during the first 6 months after cessation of anticoagulation. The initial type of the thromboembolic event (eg, arterial, venous, miscarriage) appears to be the most likely type of event to recur in a given patient [9], but there are many exceptions. Khamashta et al [10••], in a relatively large retrospective study of 147 patients with APS and a history of thrombosis, found that the median time between the initial thrombosis and the first recurrence was 12 months.…”

Section: Secondary Prevention Of Venous Thrombosismentioning

confidence: 99%

Antiphospholipid antibody syndrome

Cucurull¹,

Gharavi²,

Menon³

et al. 2003

Curr Treat Options Cardio Med

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Antiphospholipid antibody syndrome (APS) is a recently defined autoimmune disorder characterized by recurrent vascular thromboses or recurrent pregnancy morbidity; these features are linked to the presence in blood of autoantibodies against negatively charged phospholipids or phospholipid-binding proteins. Thrombosis can occur in any tissue, in veins, arteries, or the microvasculature. Pregnancy morbidity in APS includes miscarriages or premature birth. Criteria that define the major clinical and laboratory features of APS were published in 1999. In patients with antiphospholipid antibodies and prior thrombosis or pregnancy morbidity, there is a high risk of recurrence that persists as long as antiphospholipid antibodies occur in blood. This risk for recurrence of thrombosis or pregnancy morbidity is greatly reduced by preventive anticoagulant therapy. Patients presenting with thrombosis in APS are initially managed in much the same way as are patients with vascular thrombosis owing to other causes. However, in patients with APS, high-intensity anticoagulation is usually needed to prevent recurrences of thrombosis. Thrombosis in APS is often multifactorial, as with non-APS thrombosis. Therefore, in all patients with APS, other reversible risk factors for thrombosis should be sought. The pregnancy outcome of women with APS who have had prior miscarriages is greatly improved by treatment during pregnancy with a combination of heparin and low-dose aspirin.

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Clinical study and follow-up of 100 patients withthe antiphospholipid syndrome

Cited by 109 publications

References 32 publications

Antiphospholipid Antibodies in Ocular Arterial and Venous Occlusive Disease

Antiphospholipid Antibodies in Ocular Arterial and Venous Occlusive Disease

Increased mortality in patients with the lupus anticoagulant: the Vienna Lupus Anticoagulant and Thrombosis Study (LATS)

Antiphospholipid antibody syndrome

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