TY - JOUR
T1 - Thrombotic risk stratification by platelet count in patients with antiphospholipid antibodies
T2 - a longitudinal study
AU - Hisada, R.
AU - Kato, M.
AU - Sugawara, E.
AU - Fujieda, Y.
AU - Oku, K.
AU - Bohgaki, T.
AU - Amengual, O.
AU - Yasuda, S.
AU - Atsumi, T.
N1 - Publisher Copyright:
© 2017 International Society on Thrombosis and Haemostasis
PY - 2017/9
Y1 - 2017/9
N2 - Essentials Thrombotic risk stratification is an unmet need in antiphospholipid antibody carriers. Platelet count and antiphospholipid score (aPL-S) were combined to predict thrombotic events. Patients with high aPL-S are at high thrombotic risk regardless of platelet count. If platelet count is low, patients with low aPL-S are also on high thrombotic risk. Summary: Background Thrombocytopenia is a non-criteria clinical manifestation of antiphospholipid syndrome. However, it remains to be elucidated whether thrombocytopenia increases thrombotic risk in antiphospholipid antibody (aPL) carriers. Objectives To investigate the impact of platelet count in terms of predicting thrombotic events in aPL carriers, and to stratify the thrombotic risk by combining platelet count and antiphospholipid score (aPL-S), which represents a quantification of aPL varieties and titers. Patients/methods A single-center, retrospective, longitudinal study comprising 953 consecutive patients who were suspected of having autoimmune disease between January 2002 and December 2006 was performed. Low platelet count was defined as a count of < 150 × 103 μL–1 at the time of aPL testing. Results A negative correlation was observed between aPL-S and platelet count (r = − 0.2477). Among aPL-positive patients, those with a low platelet count developed thrombosis more frequently than those without (hazard ratio [HR] 2.95, 95% confidence interval [CI] 1.11–7.88). Among aPL-negative patients, no difference was found in the predictive value of thrombosis regardless of platelet count. Patients with aPLs were further divided into two subgroups according to aPL-S. Among low-aPL-S patients, those with low platelet counts developed thrombosis more frequently than those without (HR 3.44, 95% CI 1.05–11.2). In contrast, high-aPL-S patients developed thrombosis frequently regardless of platelet count. Conclusions aPL carriers with low platelet counts are at high risk of developing thrombosis. In particular, ‘low-aPL-S carriers’ may be stratified by platelet count in terms of predicting future thrombotic events.
AB - Essentials Thrombotic risk stratification is an unmet need in antiphospholipid antibody carriers. Platelet count and antiphospholipid score (aPL-S) were combined to predict thrombotic events. Patients with high aPL-S are at high thrombotic risk regardless of platelet count. If platelet count is low, patients with low aPL-S are also on high thrombotic risk. Summary: Background Thrombocytopenia is a non-criteria clinical manifestation of antiphospholipid syndrome. However, it remains to be elucidated whether thrombocytopenia increases thrombotic risk in antiphospholipid antibody (aPL) carriers. Objectives To investigate the impact of platelet count in terms of predicting thrombotic events in aPL carriers, and to stratify the thrombotic risk by combining platelet count and antiphospholipid score (aPL-S), which represents a quantification of aPL varieties and titers. Patients/methods A single-center, retrospective, longitudinal study comprising 953 consecutive patients who were suspected of having autoimmune disease between January 2002 and December 2006 was performed. Low platelet count was defined as a count of < 150 × 103 μL–1 at the time of aPL testing. Results A negative correlation was observed between aPL-S and platelet count (r = − 0.2477). Among aPL-positive patients, those with a low platelet count developed thrombosis more frequently than those without (hazard ratio [HR] 2.95, 95% confidence interval [CI] 1.11–7.88). Among aPL-negative patients, no difference was found in the predictive value of thrombosis regardless of platelet count. Patients with aPLs were further divided into two subgroups according to aPL-S. Among low-aPL-S patients, those with low platelet counts developed thrombosis more frequently than those without (HR 3.44, 95% CI 1.05–11.2). In contrast, high-aPL-S patients developed thrombosis frequently regardless of platelet count. Conclusions aPL carriers with low platelet counts are at high risk of developing thrombosis. In particular, ‘low-aPL-S carriers’ may be stratified by platelet count in terms of predicting future thrombotic events.
KW - antiphospholipid antibodies
KW - antiphospholipid syndrome
KW - platelet count
KW - thrombocytopenia
KW - thrombosis
UR - http://www.scopus.com/inward/record.url?scp=85028459016&partnerID=8YFLogxK
U2 - 10.1111/jth.13763
DO - 10.1111/jth.13763
M3 - 学術論文
C2 - 28662299
AN - SCOPUS:85028459016
SN - 1538-7933
VL - 15
SP - 1782
EP - 1787
JO - Journal of Thrombosis and Haemostasis
JF - Journal of Thrombosis and Haemostasis
IS - 9
ER -