PMID- 35143425
OWN - NLM
STAT- MEDLINE
DCOM- 20220428
LR  - 20220803
IS  - 2542-5641 (Electronic)
IS  - 0366-6999 (Print)
IS  - 0366-6999 (Linking)
VI  - 135
IP  - 6
DP  - 2022 Mar 20
TI  - Additional risk factors associated with thrombosis and pregnancy morbidity in a 
      unique cohort of antiphospholipid antibody-positive patients.
PG  - 658-664
LID - 10.1097/CM9.0000000000001964 [doi]
AB  - BACKGROUND: Antiphospholipid syndrome (APS) is an autoimmune prothrombotic 
      condition with significant morbidity. The objective of this study was to identify 
      additional clinical and epidemiological risks of arterial thrombosis, venous 
      thrombosis, and pregnancy morbidities in a large cohort of persistent 
      antiphospholipid antibodies (aPLs)-positive carriers. METHODS: This was a 
      cross-sectional cohort study of 453 consecutive patients with a documented 
      positive aPL who attended Peking University People's Hospital. Among 453 patients 
      screened, 297 patients had persistent positive aPL. We compared asymptomatic aPL 
      carriers with thrombotic and obstetric APS patients. And the univariate analysis 
      and multivariable logistic regression were used to evaluate the association 
      between different risk factors and APS clinical manifestations. The levels of 
      circulating markers of neutrophil extracellular traps (NETs) (cell-free DNA and 
      citrullinated histone H3 [Cit-H3]) were assessed and compared among aPL-positive 
      carriers with or without autoimmune disease and APS patients. RESULTS: Additional 
      risk factors associated with arterial thrombosis among aPL-positive carriers 
      included: smoking (odds ratio [OR] = 6.137, 95% confidence interval 
      [CI] = 2.408-15.637, P  = 0.0001), hypertension (OR = 2.368, 95% 
      CI = 1.249-4.491, P  = 0.008), and the presence of underlying autoimmune disease 
      (OR = 4.401, 95% CI = 2.387-8.113, P < 0.001). Additional risks associated with 
      venous thrombosis among aPL carriers included: smoking (OR = 4.594, 95% 
      CI = 1.681-12.553, P  = 0.029) and the presence of underlying autoimmune disease 
      (OR = 6.330, 95% CI = 3.355-11.940, P < 0.001). The presence of underlying 
      autoimmune disease (OR = 3.301, 95% CI = 1.407-7.744, P  = 0.006) is the 
      additional risk, which demonstrated a significant association with APS pregnancy 
      morbidity. Higher circulating levels of cell-free DNA and Cit-H3 were observed 
      among APS patients and aPL patients with autoimmune diseases compared with those 
      aPL carriers without underlying autoimmune diseases. Furthermore, control 
      neutrophils that are conditioned with APS patients'sera have more pronounced NET 
      release compared with those treated with aPL carriers'sera without underlying 
      autoimmune diseases. CONCLUSIONS: We identified several potential additional risk 
      factors for APS clinical manifestations among a large cohort of Chinese aPL 
      carriers. Our data may help physicians to risk stratify aPL-positive Asian 
      patients.
CI  - Copyright (c) 2022 The Chinese Medical Association, produced by Wolters Kluwer, 
      Inc. under the CC-BY-NC-ND license.
FAU - Li, Chun
AU  - Li C
AD  - Department of Rheumatology and Immunology, Peking University People's Hospital, 
      Beijing 100044, China.
FAU - Zuo, Yu
AU  - Zuo Y
AD  - Division of Rheumatology, Department of Internal Medicine, University of 
      Michigan, Ann Arbor, Michigan, USA.
FAU - Zhang, Song
AU  - Zhang S
AD  - Division of Biostatistics, Department of Clinical Sciences, UT Southwestern 
      Medical Center, Dallas, TX, USA.
FAU - Makris, Una E
AU  - Makris UE
AD  - Division of Biostatistics, Department of Clinical Sciences, UT Southwestern 
      Medical Center, Dallas, TX, USA.
AD  - Medical Service, VA North Texas Health Care System, Dallas, TX, USA.
FAU - Karp, David R
AU  - Karp DR
AD  - Division of Rheumatic Disease, Department of Internal Medicine, The University of 
      Texas Southwestern Medical Center, Dallas, TX, USA.
FAU - Li, Zhanguo
AU  - Li Z
AD  - Department of Rheumatology and Immunology, Peking University People's Hospital, 
      Beijing 100044, China.
LA  - eng
PT  - Journal Article
DEP - 20220320
PL  - China
TA  - Chin Med J (Engl)
JT  - Chinese medical journal
JID - 7513795
RN  - 0 (Antibodies, Antiphospholipid)
RN  - 0 (Cell-Free Nucleic Acids)
SB  - IM
MH  - Antibodies, Antiphospholipid
MH  - *Antiphospholipid Syndrome/complications
MH  - *Autoimmune Diseases
MH  - *Cell-Free Nucleic Acids
MH  - Cohort Studies
MH  - Cross-Sectional Studies
MH  - Female
MH  - Humans
MH  - Morbidity
MH  - Pregnancy
MH  - Risk Factors
MH  - *Thrombosis/etiology
PMC - PMC9276217
COIS- None.
EDAT- 2022/02/11 06:00
MHDA- 2022/04/29 06:00
PMCR- 2022/03/20
CRDT- 2022/02/10 17:15
PHST- 2021/10/04 00:00 [received]
PHST- 2022/02/11 06:00 [pubmed]
PHST- 2022/04/29 06:00 [medline]
PHST- 2022/02/10 17:15 [entrez]
PHST- 2022/03/20 00:00 [pmc-release]
AID - 00029330-202203200-00005 [pii]
AID - CMJ-2021-752 [pii]
AID - 10.1097/CM9.0000000000001964 [doi]
PST - epublish
SO  - Chin Med J (Engl). 2022 Mar 20;135(6):658-664. doi: 10.1097/CM9.0000000000001964.