ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 1799

Smoking, Antiphospholipid Antibodies and Thrombosis in SLE

Michelle Petri1, George Stojan2 and Wei Fu3, 1Rheumatology Division, Johns Hopkins University School of Medicine, Baltimore, MD, 2Rheumatology, Johns Hopkins University, Baltimore, MD, 3Division of Rheumatology, School of Medicine, Johns Hopkins University, Baltimore, MD

Meeting: 2016 ACR/ARHP Annual Meeting

Date of first publication: September 28, 2016

Keywords: , ,

Session Information

Date: Monday, November 14, 2016

Title: Systemic Lupus Erythematosus – Clinical Aspects and Treatment - Poster II: Damage Accrual and Quality of Life

Session Type: ACR Poster Session B

Session Time: 9:00AM-11:00AM

Background/Purpose:  Smoking is a risk factor for systemic lupus erythematosus and in particular for discoid lupus. A recent study, suggested that history of smoking was associated with antiphospholipid antibodies. We investigated the association between smoking and antiphospholipid antibodies in systemic lupus erythematosus as well as the relationship between smoking, antiphospholipid antibodies, and vascular events.

Methods: 2406 patients in a prospective SLE cohort had smoking assessed at baseline (ever, current, never). The lupus anticoagulant was assessed by dRVVT with mixing studies and confirmatory tests. Anticardiolipin and anti-beta2 glycoprotein 1 were measured by ELISA (INOVA). Vascular events were defined as stroke, myocardial infarction, digital gangrene, and deep vein thrombosis.

Results: Table 1 shows the frequency of each antiphospholipid antibody by smoking status. Table 2 shows the association of smoking with thrombotic events among patients with antiphospholipid antibodies. Unadjusted p-values and p-values adjusted for ethnicity are given.  Table 1: Association between Smoking and Antiphospholipid Antibodies

LAC (RVVT) Anticardiolipin Anti-beta2 glycoprotein
Ever smoking 245 (28.7%) 411 (48.1%) 149 (30%)
Past smoking 145 (29.3%) 246 (49.8%) 103 (32.4%)
Current smoking 97 (27.6%) 165 (46.6%) 46 (26.3%)
Never smoking 373 (25.3%) 721 (48.9%) 271 (28.6%)
P Value (Ever vs. Never) 0.0734 0.6943 0.5635
P Value (Past vs. Never) 0.0802 0.734 0.1986
P Value (Current vs. Never) 0.3818 0.4361 0.5346
adj. P Value (Ever vs. Never) 0.0933 0.6434 0.6169
adj. P Value (Past vs. Never) 0.1146 0.8189 0.2484
adj. P Value (Current vs. Never) 0.3893 0.4017 0.5779

  Table 2: Association between smoking and thrombosis in SLE patients with antiphospholipid antibodies

Stroke Myocardial Infarction Digital Gangrene DVT
Ever smoking 29 (3.3%) 60 (6.8%) 19 (2.2%) 121 (13.7%)
Past smoking 19 (3.8%) 34 (6.7%) 13 (2.6%) 72 (14.2%)
Current smoking 10 (2.8%) 26 (7.1%) 6 (1.6%) 47 (12.8%)
Never smoking 55 (3.7%) 49 (3.2%) 26 (1.7%) 200 (13.2%)
P Value (Ever vs.Never) 0.6901 0.0001 0.4359 0.6891
P Value (Past vs.Never) 0.9033 0.0008 0.2288 0.5611
P Value (Current vs.Never) 0.4239 0.0009 0.9246 0.8721
adj. P Value (Ever vs.Never) 0.5787 0.0001 0.5037 0.8909
adj. P Value (Past vs.Never) 0.9203 0.0010 0.2349 0.6928
adj. P Value (Current vs.Never) 0.3944 0.0012 0.8303 0.6906

   

Conclusion: There was no statistically significant association between past or current smoking and antiphospholipid antibodies in our lupus cohort. Current smokers had a slightly lower frequency of lupus anticoagulant and anti-beta2 glycoprotein 1 than past smokers. Among SLE patients with antiphospholipid antibodies, smoking was associated with myocardial infarction (p<0.01), but not with stroke, digital gangrene or venous thrombosis.

Disclosure: M. Petri, None; G. Stojan, None; W. Fu, None.

To cite this abstract in AMA style:

Petri M, Stojan G, Fu W. Smoking, Antiphospholipid Antibodies and Thrombosis in SLE [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/smoking-antiphospholipid-antibodies-and-thrombosis-in-sle/. Accessed .

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