Morbidity and mortality in the antiphospholipid syndrome during a 5-year period: a multicentre prospective study of 1000 patients
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Morbidity and mortality in the antiphospholipid syndrome during a 5-year period: a multicentre prospective study of 1000 patients. / Cervera, R; Khamashta, M A; Shoenfeld, Y; Camps, M T; Jacobsen, S; Kiss, E; Zeher, M M; Tincani, A; Kontopoulou-Griva, I; Galeazzi, M; Bellisai, F; Meroni, P L; Derksen, R H W M; de Groot, P G; Gromnica-Ihle, E; Baleva, M; Mosca, M; Bombardieri, S; Houssiau, F; Gris, J-C; Quéré, I; Hachulla, E; Vasconcelos, C; Roch, B; Fernández-Nebro, A; Piette, J-C; Espinosa, G; Bucciarelli, S; Pisoni, C N; Bertolaccini, M L; Boffa, M-C; Hughes, G R V; Euro-Phospholipid Project Group (European Forum on Antiphospholipid Antibodies).
In: Annals of the Rheumatic Diseases, Vol. 68, No. 9, 2008, p. 1428-32.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Morbidity and mortality in the antiphospholipid syndrome during a 5-year period: a multicentre prospective study of 1000 patients
AU - Cervera, R
AU - Khamashta, M A
AU - Shoenfeld, Y
AU - Camps, M T
AU - Jacobsen, S
AU - Kiss, E
AU - Zeher, M M
AU - Tincani, A
AU - Kontopoulou-Griva, I
AU - Galeazzi, M
AU - Bellisai, F
AU - Meroni, P L
AU - Derksen, R H W M
AU - de Groot, P G
AU - Gromnica-Ihle, E
AU - Baleva, M
AU - Mosca, M
AU - Bombardieri, S
AU - Houssiau, F
AU - Gris, J-C
AU - Quéré, I
AU - Hachulla, E
AU - Vasconcelos, C
AU - Roch, B
AU - Fernández-Nebro, A
AU - Piette, J-C
AU - Espinosa, G
AU - Bucciarelli, S
AU - Pisoni, C N
AU - Bertolaccini, M L
AU - Boffa, M-C
AU - Hughes, G R V
AU - Euro-Phospholipid Project Group (European Forum on Antiphospholipid Antibodies)
N1 - Keywords: Adolescent; Adult; Aged; Aged, 80 and over; Anticoagulants; Antiphospholipid Syndrome; Child; Child, Preschool; Drug Utilization; Epidemiologic Methods; Europe; Female; Humans; Infant; Infant, Newborn; Male; Middle Aged; Prognosis; Thrombosis; Young Adult
PY - 2008
Y1 - 2008
N2 - OBJECTIVES: To identify the main causes of morbidity and mortality in patients with antiphospholipid syndrome (APS) during a 5-year period and to determine clinical and immunological parameters with prognostic significance. METHODS: The clinical and immunological features of a cohort of 1000 patients with APS from 13 European countries who had been followed up from 1999 to 2004 were analysed. RESULTS: 200 (20%) patients developed APS-related manifestations during the 5-year study period. Recurrent thrombotic events appeared in 166 (16.6%) patients and the most common were strokes (2.4% of the total cohort), transient ischaemic attacks (2.3%), deep vein thromboses (2.1%) and pulmonary embolism (2.1%). When the thrombotic events occurred, 90 patients were receiving oral anticoagulants and 49 were using aspirin. 31/420 (7.4%) patients receiving oral anticoagulants presented with haemorrhage. 3/121 (2.5%) women with only obstetric APS manifestations at the start of the study developed a new thrombotic event. A total of 77 women (9.4% of the female patients) had one or more pregnancies and 63 (81.8% of pregnant patients) had one or more live births. The most common fetal complications were early pregnancy loss (17.1% of pregnancies) and premature birth (35% of live births). 53 (5.3% of the total cohort) patients died. The most common causes of death were bacterial infection (21% of deaths), myocardial infarction (19%) and stroke (13%). No clinical or immunological predictor of thrombotic events, pregnancy morbidity or mortality was detected. CONCLUSION: Patients with APS still develop significant morbidity and mortality despite current treatment (oral anticoagulants or antiaggregants, or both).
AB - OBJECTIVES: To identify the main causes of morbidity and mortality in patients with antiphospholipid syndrome (APS) during a 5-year period and to determine clinical and immunological parameters with prognostic significance. METHODS: The clinical and immunological features of a cohort of 1000 patients with APS from 13 European countries who had been followed up from 1999 to 2004 were analysed. RESULTS: 200 (20%) patients developed APS-related manifestations during the 5-year study period. Recurrent thrombotic events appeared in 166 (16.6%) patients and the most common were strokes (2.4% of the total cohort), transient ischaemic attacks (2.3%), deep vein thromboses (2.1%) and pulmonary embolism (2.1%). When the thrombotic events occurred, 90 patients were receiving oral anticoagulants and 49 were using aspirin. 31/420 (7.4%) patients receiving oral anticoagulants presented with haemorrhage. 3/121 (2.5%) women with only obstetric APS manifestations at the start of the study developed a new thrombotic event. A total of 77 women (9.4% of the female patients) had one or more pregnancies and 63 (81.8% of pregnant patients) had one or more live births. The most common fetal complications were early pregnancy loss (17.1% of pregnancies) and premature birth (35% of live births). 53 (5.3% of the total cohort) patients died. The most common causes of death were bacterial infection (21% of deaths), myocardial infarction (19%) and stroke (13%). No clinical or immunological predictor of thrombotic events, pregnancy morbidity or mortality was detected. CONCLUSION: Patients with APS still develop significant morbidity and mortality despite current treatment (oral anticoagulants or antiaggregants, or both).
U2 - 10.1136/ard.2008.093179
DO - 10.1136/ard.2008.093179
M3 - Journal article
C2 - 18801761
VL - 68
SP - 1428
EP - 1432
JO - Annals of the Rheumatic Diseases
JF - Annals of the Rheumatic Diseases
SN - 0003-4967
IS - 9
ER -
ID: 20008664