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Thromb Haemost. Author manuscript; available in PMC Oct 26, 2012.
Published in final edited form as:
PMCID: PMC3482244
CAMSID: CAMS2357
Thromboembolic risk in patients with high titre anticardiolipin and multiple antiphospholipid antibodies
Carolyn Neville,1 Joyce Rauch,2 Jeannine Kassis,3 Erika R. Chang,4 Lawrence Joseph,1,5 Martine Le Comte,1 and Paul R. Fortin4,6
1Division of Clinical Epidemiology, The Montreal General Hospital, McGill University Health Centre, Montreal, Quebec, Canada
2Department of Rheumatology, The Montreal General Hospital, McGill University Health Centre, Montreal, Quebec, Canada
3Laboratoire de Coagulation, Hôpital Maisonneuve-Rosemont, Université de Montréal, Montreal, Quebec, Canada
4Division of Outcomes and Population Health, University Health Network, University of Toronto, Toronto, Ontario, Canada
5Department of Epidemiology and Biostatistics, McGill University, Montreal, Quebec, Canada
6Division of Rheumatology, University Health Network, University of Toronto, Toronto, Ontario, Canada
Correspondence to: Paul R. Fortin MD, MPH, FRCP(C), Director of Clinical Research, Arthritis Centre of Excellence, Toronto Western Hospital, Room FP-1-214, 399 Bathurst Street, Toronto, Ontario, Canada M5T 2S8, Tel.: (416) 603-5664, Fax: (416) 603-4348, paul.fortin/at/uhn.on.ca
Summary
Asymptomatic antiphospholipid antibody (aPL) carriers with high risk for thrombosis may benefit from preventive anticoagulation.
It was our objective to test whether the risk of thrombosis increases with: 1) increasing titres of anticardiolipin antibodies (aCL) after adjustment for other cardiovascular risk factors and 2) the number of aPL detected.
In a cross-sectional study, blood was collected from clinics in two teaching hospitals. The study included 208 individuals suspected of having an aPL and 208 age- and sex-matched controls having blood drawn for a complete blood count.
Clinical variables included history of previous arterial (ATE) or venous (VTE) thrombotic events, traditional risk factors for cardiovascular disease, and systemic lupus erythematosus (SLE). Laboratory variables included IgG/IgM aCL, lupus anticoagulant, and IgG/IgM anti-β2-glycoprotein I.
Mean age was 46.5 years and 83% were female. Seventy-five of the 416 participants had ≥ 1 aPL, and 69 had confirmed ≥ 1 ATE or VTE. Family history was positive in 48% of participants, smoking in 28%, hypertension in 16%, diabetes in 6%, and SLE in 20%. A 10-unit increase in aCL IgG titre was associated with an odds ratio (OR) [95% CI] of 1.07 [1.01–1.13] for ATE and 1.06 [1.02 – 1.11] for VTE. The odds of a previous thrombosis increased with each additional aPL detected: 1.5 [0.93–2.3] for ATE and 1.7 [1.1–2.5] for VTE.
These results indicate that increased titres of aCL and multiple aPL were associated with an increased risk of a previous thrombotic event.
Keywords: Antiphospholipid syndrome, antiphospholipid antibodies, anti-cardiolipin antibody, thrombosis