AI Article Synopsis
- Antiphospholipid syndrome (APS) is linked to increased damage accrual despite anticoagulant therapy, which adversely affects patient quality of life.
- A study analyzing 282 APS patients found that 28.4% experienced significant damage, with neuropsychiatric issues as the most common complication.
- Risk factors for damage included microangiopathy and non-criteria symptoms, which raised the likelihood of damage accrual significantly, indicating a need for closer monitoring of these patients.
Article Abstract
Background: Despite anticoagulant therapy, a antiphospholipid syndrome (APS) has a higher rate of recurrent events, which can lead to damage accrual and a negative impact on life quality.
Objectives: To evaluate the risk factors and APS subsets associated with damage accrual.
Patients/methods: We conducted a retrospective single-center study. We reviewed the medical records of 282 APS patients, with a median age of 36 (IQR 30-46) years and a median of 195 (IQR 137-272) months. The primary endpoint was damage accrual during follow-up, defined as organ/tissue impairment present for at least six months or causing permanent loss. The secondary endpoints were early organ damage within six months of disease onset and death.
Results: Eighty (28.4%) patients presented damage accrual; 52.5% developed damage within six months of APS onset, and 41.3% had more than one organ involved. Neuropsychiatric involvement, affecting 38.8% of the patients, was the most frequent, followed by peripheral vasculopathy and renal involvement, 35% either. Death happened in 7 (2.5 %) patients; damage accrual was associated with a 6-fold risk of death [OR 6.7 (95% CI 1.3-35.1), p = 0.03]. Microangiopathy and non-criteria manifestations were independent risk factors for damage accrual with 5-fold and 4-fold higher risk, respectively [(OR 4.9 (95% CI 2.1-11.7), p < 0.0001 and (OR 3.8 (95% CI 1.5-10.1), p = 0.007]. The cumulative incidence of damage accrual increased by 5.7-fold and 3.6-fold in patients with microangiopathy and non-criteria manifestations.
Conclusions: APS patients had a higher frequency of damage accrual. Microangiopathy and non-criteria manifestations were independent risk factors for damage accrual.
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| http://dx.doi.org/10.1016/j.jaut.2024.103180 | DOI Listing |
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