Background/Purpose: Risk stratification of asymptomatic aPL carriers is difficult. Our objective was to identify additional clinical and epidemiological predictors of arterial thrombosis, venous thrombosis, and pregnancy morbidities in a large cohort of Chinese aPL carriers.

Methods: This cohort included 297 consecutive persistent aPL positive patients who attended the rheumatology clinic at Peking University People’s Hospital. Among those, 85 had arterial thrombosis, 76 had venous thrombosis, and 34 experienced APS related pregnancy morbidities. 143 patients had at least one persistent positive aPL without any other criteria APS manifestations and were defined as aPL positive control patients. When assessing risk factors associated with pregnancy morbidities, only reproductive age (age<45) female controls were used. Pearson Chi-squared analysis and multivariable logistic regression were used to evaluate correlation between different risk factors and clinical manifestations.

Results: When comparing to asymptomatic aPL positive controls, additional risk factors associated with arterial thrombosis included: hypertension (OR=2.368, 95% CI 1.249 – 4.491, P=0.0083), smoking (OR=6.137, 95% CI 2.408 – 15.637, P=0.0001), and the presence of underlying autoimmune disease (OR=4.401, 95% CI 2.387- 8.113, P<0.0001). Additional risks associated with venous thrombosis included: smoking (OR=4.594, 95%CI 1.681 – 12.553, P=0.029) and the presence of underlying autoimmune disease (OR=6.33, 95%CI 3.355 – 11.94, P<0.0001). The presence of underlying autoimmune disease (OR= 3.301, 95%CI 1.407 – 7.744, P=0.0061) is the only additional risk which demonstrated a significant association with pregnancy morbidity. A high frequency of thrombocytopenia and hypocomplementemia were observed in all +aPLs patients.

Conclusion: Hypertension is a potential predictor for arterial thrombosis. Smoking and the presence of underlying autoimmune disease are potential predictors for both arterial and venous thrombosis among aPL carriers. The presence of underlying autoimmune disease is an additional risk for APS related pregnancy morbidities in +aPL Chinese patients. This is the largest cross sectional comparison between Chinese APS patients and asymptomatic aPL carriers where we are able to identify additional risk factors for thromboembolic events and pregnancy morbidities. Our data may help physicians to risk stratify aPLs positive Asian patients.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/identifying-additional-risk-factors-associated-with-thrombosis-and-pregnancy-morbidity-in-a-unique-cohort-of-antiphospholipid-antibody-positive-chinese-patients/