Background/Purpose: The adjusted Global AntiPhospholipid Syndrome Score (aGAPSS) was described as a tool to estimate the risk of thromboses in patients with APS. The aim of this study is to evaluate if higher values of aGAPSS correlate with the presence of arterial or venous thromboses in thrombotic primary APS patients.

Methods: A cross-sectional study was performed in a group of 72 outpatients who fulfilled thrombotic pAPS classification criteria (Sydney). Clinical and serologic features were collected during visits and by chart review. aGAPSS was calculated for each patient and correlated to arterial and venous thromboses. Statistical analysis was performed using chi-square, Mann-Whitney U and Spearman’s R when applicable. Multivariate regression analysis included age, sex, race and variables with p<0.10 in the bivariate analysis.

Results: Thirty-seven (51.4%) patients had arterial events and 51 (70.8%) had venous thromboses. The mean number of episodes of arterial and venous thromboses was 1.65 and 1.4 per patient, respectively. The median aGAPSS of the 72 patients included in the analysis was 9 (7-13); this was used to divide two groups of patients: low aGAPSS (<10) and high aGAPSS (≥10). Patients with or without arterial thromboses were compared regarding the presence of high aGAPSS. In a bivariate analysis, higher aGAPSS correlated with the presence of arterial thromboses (p=0.018). In a multivariate regression analysis, higher aGAPSS remained as a risk factor for the presence of arterial thromboses (OR 3.4, 95%CI 1.26-9.2, p=0.016). Demographic and clinical characteristics of this group of patients are shown in Table 1. Regarding venous thrombosis, there was a tendency towards higher levels of aGAPSS (p=0.063). To avoid contamination of data, a new different analysis was performed. Patients who presented both arterial and venous thromboses were excluded, and 2 groups were created, one with arterial exclusive events (N=19) and another with venous exclusive events (N=35). The group with arterial exclusive thromboses had higher values of aGAPSS (p=0.007). In the multivariate analysis, high aGAPSS was associated with increased risk of arterial events (OR 4.95, 95%CI 1.49-16.47). Patients with both arterial and venous thromboses did not have higher aGAPSS (p=0.677).

Conclusion: The presence of arterial events was associated with higher values of aGAPSS. aGAPSS seems to be a tool capable to detect high risk thrombotic patients, particularly arterial events.

Table 1: Demographic and clinical characteristics (N=72).

Values showed as N(%) for categorical variables, Mean± SD for normal distribution and Median (interquartil range) for asymmetrical distribution.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/arterial-events-in-primary-antiphospholipid-syndrome-are-associated-with-high-values-of-the-adjusted-global-antiphospholipid-syndrome-score/