Ethnicity and Antiphospholipid Syndrome in Israel

Abstract

Objective. Antiphospholipid syndrome (APS) is an acquired coagulopathy associated with the presence of antiphospholipid antibodies. Whether ethnicity modulates APS clinical course is not known. The aim of our study was to assess the interplay of ethnicity and APS in Israel.Methods. We retrospectively evaluated the ethnic distribution of APS patients from 3 medical centers in Israel compared to the general population. Ethnic groups were defined according to the Israeli Bureau of Statistics as Ashkenazi (European), former Union of Soviet Socialist Republics (USSR), North African, Asian (West Asia, Greece, and Turkey), Israeli Arab individuals, and others.Results. Our cohort included 382 patients. The prevalence of Ashkenazi and Asian ethnicities was more pronounced (33% versus 12.8% and 15.4% versus 7.7%, respectively; P < 0.001), while Israeli Arabs were less represented (5.2% versus 31.1%; P < 0.001) relative to their part in the general population. Arab patients were younger at presentation (mean ± SD 28 ± 10 years versus 34 ± 13 years; P < 0.001) and were more likely to present with venous thrombosis (50% versus 35%; P = 0.037) and to suffer from venous thrombotic recurrence (45% versus 16%; P < 0.001) compared to other ethnicities. Mortality was higher among patients of Asian ethnic origin (8.8% versus 1.1%; P = 0.005); intriguingly, this group experienced cardiovascular risk factors more often (i.e., dyslipidemia and hypertension).Conclusion. Ethnicity may affect the prevalence and/or natural course of APS, which is less prevalent and differs clinically in Israeli Arab patients, while mortality was linked with Asian ethnicity.

Antiphospholipid antibodies in pulmonary embolism treated with direct oral anticoagulants: Prevalence data from unselected consecutive patients

“…The lack of specific information on the race and ethnicity of the patients is another limitation. Data evaluating whether race and ethnicity affect the prevalence of APS are scarce; however, few studies have suggested that they play a role [ 23 , 24 ]. All our participants were from a single center in Denmark and were expected to be predominately Caucasian.…”

A genome-wide association study suggests new susceptibility loci for primary antiphospholipid syndrome

“…The clinical variability in PAPS makes it challenging to accurately estimate the incidence and prevalence of this disease in different populations [4]. Despite this, population-based studies report a higher prevalence of PAPS, as well as a higher mortality, in Asian populations [48]. It is noteworthy that possible variability in the strength of genetic associations at the detected loci between populations might affect the accuracy of interpreting these results.…”

Risk Factors for Antiphospholipid Antibodies and Antiphospholipid Syndrome

“…A study showed that Japanese APS patients tend to have more arterial events than Europeans, while the latter group is more prone to suffer venous events (estimated prevalence: 23.4 vs. 38.9%, respectively). 59 In an Israeli study, 60 Arab patients, compared to the other ethnicities studied (Asians and Ashkenazi Jews), were younger and more prone to venous thrombosis recurrence (46 vs. 16%), though mortality was higher in the Asian group (8.8 vs. 1.1%). In a Spanish cohort, 61 a higher prevalence of APS was found in Roma SLE patients compared to Caucasians, highlighting a higher prevalence of abortions in the former group.…”