Identifying “Second Hit” Risk Factor(s) Associated with Thrombosis and Pregnancy Morbidity in Ethnically Diverse Antiphospholipid Antibodies Positive Patients

Yu Zuo¹, Jennifer Fan², Ravi Sarode¹, Song Zhang², Una E. Makris¹, David Karp³ and Yu-min Shen², ¹University of Texas Southwestern Medical Center, Dallas, TX, ²University of Texas Southwestern Medical Center, dallas, TX, ³Rheumatology, UT Southwestern Med Ctr, Dallas, TX

Meeting: ACR/ARHP Annual Meeting 2017

Date of first publication: September 18, 2017

Keywords: Antiphospholipid antibodies, antiphospholipid syndrome, pregnancy and thrombosis

Session Information

Date: Sunday, November 5, 2017

Title: Antiphospholipid Syndrome Poster

Session Type: ACR Poster Session A

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

Background/Purpose: The evaluation of thrombotic and pregnancy risks associated with antiphospholipid antibodies (aPL) in individual patients without APS clinical manifestation is challenging. Our aim is to identify potential predictors of thrombosis and pregnancy morbidities among aPL positive patients.

Methods: This study included 229 consecutive persistent aPL positive patients who attended clinic at University of Texas Southwestern Medical Center. All patients had persistent high titer (99 percentiles) aPL. The aPL profiles were assessed with commercial assay. Hypertension (HTN) was classified based on 8^th Joint National Committee guidelines. Hyperlipidemia (HLD) was defined as fasting total cholesterol >200 mg/dl. 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: Of the 229 aPL positive patients, 130 (56.8%) patients had criteria APS clinical manifestations and 99 patients did not. 46% were Caucasian, 26% of African descent, 18% Hispanic, 2% Asian, and 8% were unspecified. Among traditional risk factors and signs of endothelial injury, only hypertension demonstrated an independent association with arterial thrombosis (OR=3.826, 95%CI 1.597 – 9.167, P=0.0026), and LA demonstrated an independent association with venous thrombosis (OR=3.308, 95%CI 1.544 – 7.085, P=0.0021). Fisher’s exact test showed a marginally significant association between Caucasian race and thrombosis (P=0.045); however, multivariable analysis did not confirm an independent association. Age, diabetes, hypercholesterolemia, smoking, Raynaud’s phenomenon, livedo reticularis, and triple positive aPLs were not significantly associated with either arterial or venous thrombosis. None of the evaluated risk factors demonstrated a significant association with pregnancy morbidity.

Conclusion: HTN is a potential predictor of arterial thrombosis and the presence of LA is a potential predictor of venous thrombosis in aPL positive patients.

Disclosure: Y. Zuo, None; J. Fan, None; R. Sarode, None; S. Zhang, None; U. E. Makris, None; D. Karp, None; Y. M. Shen, None.

To cite this abstract in AMA style:

Zuo Y, Fan J, Sarode R, Zhang S, Makris UE, Karp D, Shen YM. Identifying “Second Hit” Risk Factor(s) Associated with Thrombosis and Pregnancy Morbidity in Ethnically Diverse Antiphospholipid Antibodies Positive Patients [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/identifying-second-hit-risk-factors-associated-with-thrombosis-and-pregnancy-morbidity-in-ethnically-diverse-antiphospholipid-antibodies-positive-patients/. Accessed .

ACR Meeting Abstracts - https://acrabstracts.org/abstract/identifying-second-hit-risk-factors-associated-with-thrombosis-and-pregnancy-morbidity-in-ethnically-diverse-antiphospholipid-antibodies-positive-patients/