1
|
Zuily S, de Laat B, Mohamed S, Kelchtermans H, Shums Z, Albesa R, Norman GL, Lamboux-Matthieu C, Rat AC, Ninet J, Magy-Bertrand N, Pasquali JL, Lambert M, Lorcerie B, Kaminsky P, Guillemin F, Regnault V, Wahl D. Validity of the global anti-phospholipid syndrome score to predict thrombosis: a prospective multicentre cohort study. Rheumatology (Oxford) 2015; 54:2071-5. [PMID: 26163690 DOI: 10.1093/rheumatology/kev238] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Indexed: 11/13/2022] Open
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.
Collapse
Affiliation(s)
- Stéphane Zuily
- 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,
| | - Bas de Laat
- 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
| | - Shirine Mohamed
- Nancy School of Medicine, Université de Lorraine, Nancy, France, CHU de Nancy, Orphan Disease Unit, Nancy, France
| | - Hilde Kelchtermans
- Biochemistry, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht
| | - Zakera Shums
- Research and Development, Inova Diagnostics, San Diego, CA, USA
| | - Roger Albesa
- Research and Development, Inova Diagnostics, San Diego, CA, USA
| | - Gary L Norman
- Research and Development, Inova Diagnostics, San Diego, CA, USA
| | - Claire Lamboux-Matthieu
- CHU de Nancy, Regional Competence Centre for Rare Vascular and Systemic Autoimmune Diseases, Vascular Medicine Division
| | - Anne-Christine Rat
- 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
| | | | | | - Jean-Louis Pasquali
- CHU de Strasbourg, Internal Medicine and Clinical Immunology Department, Strasbourg, F-67000
| | - Marc Lambert
- CHRU de Lille, Department of Internal Medicine, Lille
| | - Bernard Lorcerie
- CHU de Dijon, Internal Medicine and Clinical Immunology Department, Dijon and
| | - Pierre Kaminsky
- Nancy School of Medicine, Université de Lorraine, Nancy, France, CHU de Nancy, Orphan Disease Unit, Nancy, France
| | - Francis Guillemin
- Université de Lorraine, Paris Descartes University, APEMAC, EA 4360, Inserm, CIC-EC 1433, CHU de Nancy, Clinical Epidemiology and Evaluation Department
| | | | - Denis Wahl
- 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
| | | |
Collapse
|